Obsessions and compulsions

مِن شَرِّ ٱلۡوَسۡوَاسِ ٱلۡخَنَّاسِ

against the harm of the slinking whisperer––

وَكَمۡ أَهۡلَكۡنَا قَبۡلَهُم مِّن قَرۡنٍ هَلۡ تُحِسُّ مِنۡهُم مِّنۡ أَحَدٍ أَوۡ تَسۡمَعُ لَهُمۡ رِكۡزَۢا

How many generations We have destroyed before them! Do you perceive a single one of them now, or hear as much as a whisper

يَوۡمَئِذࣲ يَتَّبِعُونَ ٱلدَّاعِيَ لَا عِوَجَ لَهُۥۖ وَخَشَعَتِ ٱلۡأَصۡوَاتُ لِلرَّحۡمَٰنِ فَلَا تَسۡمَعُ إِلَّا هَمۡسࣰ ا

On that Day, people will follow the summoner from whom there is no escape; every voice will be hushed for the Lord of Mercy; only whispers will be heard

فَوَسۡوَسَ إِلَيۡهِ ٱلشَّيۡطَٰنُ قَالَ يَٰٓـَٔادَمُ هَلۡ أَدُلُّكَ عَلَىٰ شَجَرَةِ ٱلۡخُلۡدِ وَمُلۡكࣲ لَّا يَبۡلَىٰ

But Satan whispered to Adam, saying, ‘Adam, shall I show you the tree of immortality and power that never decays?’

وَلَقَدۡ خَلَقۡنَا ٱلۡإِنسَٰنَ وَنَعۡلَمُ مَا تُوَسۡوِسُ بِهِۦ نَفۡسُهُۥۖ وَنَحۡنُ أَقۡرَبُ إِلَيۡهِ مِنۡ حَبۡلِ ٱلۡوَرِيدِ

We created man––We know what his soul whispers to him: We are closer to him than his jugular vein––

فَوَسۡوَسَ لَهُمَا ٱلشَّيۡطَٰنُ لِيُبۡدِيَ لَهُمَا مَا وُۥرِيَ عَنۡهُمَا مِن سَوۡءَٰتِهِمَا وَقَالَ مَا نَهَىٰكُمَا رَبُّكُمَا عَنۡ هَٰذِهِ ٱلشَّجَرَةِ إِلَّآ أَن تَكُونَا مَلَكَيۡنِ أَوۡ تَكُونَا مِنَ ٱلۡخَٰلِدِينَ

Satan whispered to them so as to expose their nakedness, which had been hidden from them: he said, ‘Your Lord only forbade you this tree to prevent you becoming angels or immortals,’

from the evil of the slinking whisperer Satan — he is referred to by the name of the action waswasa on account of his repeated engaging in it — who slinks away and recoils from the heart whenever God is mentioned

Say: "I seek refuge with the Lord of An-Nas, (1)"The King of An-Nas, (2)"The God of An-Nas, (3)"From the evil of the whisperer who withdraws. (4)"Who whispers in the breasts of An-Nas. (5)"Of Jinn and An-Nas. (6) These are three attributes from the attributes of the Lord, the Mighty and Majestic. They are lordship, sovereignty and divinity. Thus, He is the Lord of everything, the King of everything and the God of everything. All things are created by Him, owned by Him, and subservient to Him. Therefore, He commands whoever is seeking protection to seek refuge with the One Who has these attributes from the evil of the whisperer who withdraws. This (the whisperer) is the devil that is assigned to man. For verily, there is not any of the Children of Adam except that he has a companion that beautifies wicked deeds for him. This devil will go to any lengths to confuse and confound him. The o

Then Satan whispered to them to show them their shameful parts that were hidden from them. This also is a mark of solicitude and a proof of generosity, for they sinned, but He turned it over to Satan's whispering. Then He increased the solicitude. He said, “to show them their shameful parts that were hidden from them.” He said: “He made their pudenda appear to them, but not to others.” They say that afterwards, Adam and Iblis met. Adam said, “You wretch! Do you know what you did to me and what dust you stirred up in my road?” Iblis said, “O Adam, I take it that I took you from the road. Tell me then, who took me from the road?” They also say that both of them turned away from the command, but there is a difference be- tween the two. Adam slipped because of appetite, and Iblis slipped because of pride. Being pride- ful is worse than satisfying appetite. When a sin arises from appetite, th

And how many — in other words many — a generation namely how many a community from among the communities of the past We have destroyed before them for their denial of Our messengers. Can you see can you find so much as one of them or hear from them so much as the faintest sound? No indeed! So just as We destroyed those folk We shall destroy these Meccans.

Then Satan Iblīs whispered to them that he might manifest reveal to them that which was hidden wūriya based on the verbal form fū‘ila and derives from the infinitive al-muwārā to them of their shameful parts. And he said ‘Your Lord prohibited you from this tree only in aversion lest you become angels malakayn may also be read malikayn or become immortals’ in other words that is the necessary consequence of eating from it as is stated in another verse Shall I guide you to the Tree of Immortality and a kingdom that does not waste away? Q. 20120.

Verily, those who believe and work deeds of righteousness, the Most Gracious will bestow love for them (96)So, We have made this easy in your own tongue, only that you may give glad tidings to those who have Taqwa, and warn with it the people that are Ludda (97)And how many a generation before them have We destroyed! Can you find a single one of them or hear even a whisper of them (98) Allah places Love of the Righteous People in the Hearts Allah, the Exalted, informs about His believing servants, who work righteous deeds – deeds that He is pleased with because they are in accordance with the legislation of Muhammad ﷺ – that He plants love for them in the hearts of His righteous servants. This is something that is absolutely necessary and there is no avoiding it. This has been reported in authentic Hadiths of the Messenger of Allah ﷺ in various different ways. Imam Ahmad recorded that

حَدَّثَنَا عَبْدُ اللَّهِ بْنُ يُوسُفَ، أَخْبَرَنَا مَالِكٌ، عَنْ يَحْيَى بْنِ سَعِيدٍ، عَنْ عَبْدِ الرَّحْمَنِ الأَعْرَجِ، عَنْ عَبْدِ اللَّهِ ابْنِ بُحَيْنَةَ ـ رضى الله عنه ـ أَنَّهُ قَالَ إِنَّ رَسُولَ اللَّهِ صلى الله عليه وسلم قَامَ مِنِ اثْنَتَيْنِ مِنَ الظُّهْرِ لَمْ يَجْلِسْ بَيْنَهُمَا، فَلَمَّا قَضَى صَلاَتَهُ سَجَدَ سَجْدَتَيْنِ ثُمَّ سَلَّمَ بَعْدَ ذَلِكَ‏.‏

Narrated `Abdullah bin Buhaina:Allah's Messenger (ﷺ) got up after the second rak`a of the Zuhr prayer without sitting in between (the second and the third rak`at). When he finished the prayer he performed two prostrations (of Sahu) and then finished the prayer with Taslim

حَدَّثَنَا أَبُو الْوَلِيدِ، حَدَّثَنَا شُعْبَةُ، عَنِ الْحَكَمِ، عَنْ إِبْرَاهِيمَ، عَنْ عَلْقَمَةَ، عَنْ عَبْدِ اللَّهِ ـ رضى الله عنه ـ أَنَّ رَسُولَ اللَّهِ صلى الله عليه وسلم صَلَّى الظُّهْرَ خَمْسًا فَقِيلَ لَهُ أَزِيدَ فِي الصَّلاَةِ فَقَالَ ‏ "‏ وَمَا ذَاكَ ‏"‏‏.‏ قَالَ صَلَّيْتَ خَمْسًا‏.‏ فَسَجَدَ سَجْدَتَيْنِ بَعْدَ مَا سَلَّمَ‏.‏

Narrated' `Abdullah:Once Allah's Messenger (ﷺ) offered five rak`at in the Zuhr prayer, and somebody asked him whether there was some increase in the prayer. Allah's Messenger (ﷺ) said, "What is that?" He said, "You have offered five rak`at." So Allah's Messenger (ﷺ) performed two prostrations of Sahu after Taslim

أَخْبَرَنَا سُلَيْمَانُ بْنُ دَاوُدَ، وَالْحَارِثُ بْنُ مِسْكِينٍ، قِرَاءَةً عَلَيْهِ وَأَنَا أَسْمَعُ، عَنِ ابْنِ وَهْبٍ، عَنْ عَمْرِو بْنِ الْحَارِثِ، عَنْ بُكَيْرٍ، أَنَّ أَبَا السَّائِبِ، حَدَّثَهُ أَنَّهُ، سَمِعَ أَبَا هُرَيْرَةَ، يَقُولُ قَالَ رَسُولُ اللَّهِ صلى الله عليه وسلم ‏‏ "‏‏ لاَ يَغْتَسِلْ أَحَدُكُمْ فِي الْمَاءِ الدَّائِمِ وَهُوَ جُنُبٌ ‏‏"‏‏ ‏‏.‏‏

Abu Hurairah said:"The Messenger of Allah (ﷺ) said: 'None of you should perform ghusl in standing water while he is Junub

أَخْبَرَنَا مُحَمَّدُ بْنُ حَاتِمٍ، قَالَ حَدَّثَنَا حِبَّانُ، قَالَ حَدَّثَنَا عَبْدُ اللَّهِ، عَنْ مَعْمَرٍ، عَنْ هَمَّامِ بْنِ مُنَبِّهٍ، عَنْ أَبِي هُرَيْرَةَ، عَنِ النَّبِيِّ صلى الله عليه وسلم قَالَ ‏‏ "‏‏ لاَ يَبُولَنَّ الرَّجُلُ فِي الْمَاءِ الدَّائِمِ ثُمَّ يَغْتَسِلُ مِنْهُ أَوْ يَتَوَضَّأُ ‏‏"‏‏ ‏‏.‏‏

It was narrated from Abu Hurairah that the Messenger of Allah (ﷺ) said:"None of you should urinate into standing water and then perform Ghusl or Wudu' with it

أَخْبَرَنَا أَبُو عَبْدِ الرَّحْمَنِ، أَحْمَدُ بْنُ شُعَيْبٍ قَالَ أَنْبَأَنَا عَمْرُو بْنُ عَلِيٍّ، قَالَ حَدَّثَنَا أَبُو عَاصِمٍ، قَالَ حَدَّثَنَا ابْنُ أَبِي ذِئْبٍ، قَالَ حَدَّثَنِي أَسِيدُ بْنُ أَبِي أَسِيدٍ، عَنْ مُعَاذِ بْنِ عَبْدِ اللَّهِ، عَنْ أَبِيهِ، قَالَ أَصَابَنَا طَشٌّ وَظُلْمَةٌ فَانْتَظَرْنَا رَسُولَ اللَّهِ صلى الله عليه وسلم لِيُصَلِّيَ بِنَا ثُمَّ ذَكَرَ كَلاَمًا مَعْنَاهُ فَخَرَجَ رَسُولُ اللَّهِ صلى الله عليه وسلم لِيُصَلِّيَ بِنَا فَقَالَ ‏"‏ قُلْ ‏"‏ ‏.‏ فَقُلْتُ مَا أَقُولُ قَالَ ‏"‏ ‏{‏ قُلْ هُوَ اللَّهُ أَحَدٌ ‏}‏ وَالْمُعَوِّذَتَيْنِ حِينَ تُمْسِي وَحِينَ تُصْبِحُ ثَلاَثًا يَكْفِيكَ كُلَّ شَىْءٍ ‏"‏ ‏.‏

It was narrated from Mu'adh bin 'Abdullah that his father said:"It was raining and dark, and we were waiting for the Messenger of Allah [SAW] to lead us in prayer. Then the Messenger of Allah [SAW] came out to lead us in prayer and he said: 'Say.' I said: 'What should I say?' He said: 'Say: He is Allah, (the) One and Al-Mu'awwadhatain in the evening and in the morning, three times, and that will suffice you against everything

أَخْبَرَنَا مُحَمَّدُ بْنُ عَلِيٍّ، قَالَ حَدَّثَنِي الْقَعْنَبِيُّ، عَنْ عَبْدِ الْعَزِيزِ، عَنْ عَبْدِ اللَّهِ بْنِ سُلَيْمَانَ، عَنْ مُعَاذِ بْنِ عَبْدِ اللَّهِ بْنِ خُبَيْبٍ، عَنْ أَبِيهِ، عَنْ عُقْبَةَ بْنِ عَامِرٍ الْجُهَنِيِّ، قَالَ بَيْنَا أَنَا أَقُودُ، بِرَسُولِ اللَّهِ صلى الله عليه وسلم رَاحِلَتَهُ فِي غَزْوَةٍ إِذْ قَالَ ‏"‏ يَا عُقْبَةُ قُلْ ‏"‏ ‏.‏ فَاسْتَمَعْتُ ثُمَّ قَالَ ‏"‏ يَا عُقْبَةُ قُلْ ‏"‏ ‏.‏ فَاسْتَمَعْتُ فَقَالَهَا الثَّالِثَةَ فَقُلْتُ مَا أَقُولُ فَقَالَ ‏"‏ ‏{‏ قُلْ هُوَ اللَّهُ أَحَدٌ ‏}‏ ‏"‏ ‏.‏ فَقَرَأَ السُّورَةَ حَتَّى خَتَمَهَا ثُمَّ قَرَأَ ‏{‏ قُلْ أَعُوذُ بِرَبِّ الْفَلَقِ ‏}‏ وَقَرَأْتُ مَعَهُ حَتَّى خَتَمَهَا ثُمَّ قَرَأَ ‏{‏ قُلْ أَعُوذُ بِرَبِّ النَّاسِ ‏}‏ فَقَرَأْتُ مَعَهُ حَتَّى خَتَمَهَا ثُمَّ قَالَ ‏"‏ مَا تَعَوَّذَ بِمِثْلِهِنَّ أَحَدٌ ‏"‏ ‏.‏

It was narrated that 'Uqbah bin 'Amir Al-Juhani said:"While I was leading the Messenger of Allah [SAW] on his mount on a military campaign, he said: 'O 'Uqbah, say!' I listened, then he said: 'O 'Uqbah, say!' I listened, then he said it a third time. I said: 'What should I say?' He said: 'Say: He is Allah, (the) One...' and he recited the Surah to the end. Then he recited: 'Say: I seek refuge with (Allah) the Lord of the daybreak...' and I recited it with him until the end. Then he recited: 'Say: I seek refuge with (Allah) the Lord of mankind...' and I recited it with him until the end. Then he said: 'No one ever sought refuge (with Allah) by means of anything like them

فإن كان يؤذيه ذلك فليرش عليه الماء حتى يقوى في نفسه ذلك ولا يتسلط عليه الشيطان بالوسواس

ولم يجدوا إلا الوسواس والكراهة له ولا يمكن أن يقال أراد بصريح الإيمان الوسوسة فلم يبق إلا حمله على الكراهة المساوقة للوسوسة والرياء وإن كان عظيما فهو دون الوسوسة في حق الله تعالى فإذا اندفع ضرر الأعظم بالكراهة فبأن يندفع بها ضرر الأصغر أولى وكذلك يروى عن النبي صلى الله عليه وسلم في حديث ابن عباس أنه قال الحمد لله الذي رد كيد الشيطان إلى الوسوسة + حديث ابن عباس الحمد لله الذي رد كيد الشيطان إلى الوسوسة أخرجه أبو داود والنسائي في اليوم والليلة بلفظ كيده

| بيان تسلط الشيطان على القلب بالوساوس ومعنى الوسوسة وسبب غلبتها

وكان بعضهم يخفف الصلاة خيفة الوسواس وروى أن عمار بن ياسر صلى صلاة فأخفها فقيل له خففت يا أبا اليقظان فقال هل رأيتموني نقصت من حدودها شيئا قالوا لا قال إني بادرت سهو الشيطان إن رسول الله صلى الله عليه وسلم قال إن العبد ليصلي الصلاة لا يكتب له نصفها ولا ثلثها ولا ربعها ولا خمسها ولا سدسها ولا عشرها وكان يقول إنما يكتب للعبد من صلاته ما عقل منها + حديث إن عمار بن ياسر صلى فأخفها فقيل له خففت يا أبا اليقظان الحديث @QB@ وفيه @QE@ إن العبد ليصلي صلاة لا يكتب له نصفها ولا ثلثها إلى آخره أخرجه أحمد بإسناد صحيح وتقدم المرفوع عنه وهو عند أبي داود والنسائي + ويقال إن طلحة والزبير وطائفة من الصحابة رضي الله عنهم كانوا أخف الناس صلاة وقالوا نبادر بها وسوسة الشيطان

وقد كره السلف بيع السيف في وقت الفتنة خيفة أن يشتريه ظالم فهذا ورع فوق الأول والكراهية فيه أخف ويليه ما هو مبالغة ويكاد يلتحق بالوسواس وهو قول جماعة أنه لا تجوز معاملة الفلاحين بآلات الحارث لأنهم يستعينون بها على الحراثة ويبيعون الطعام من الظلمة ولا يباع منهم البقر والفدان وآلات الحرث وهذا ورع الوسوسة إذ ينجر إلى أن لا يباع من الفلاح طعام لأنه يتقوى به على الحراثة ولا يسقي من الماء العام لذلك وينتهي هذا حد التنطع المنهي عنه وكل متوجه إلى شيء على قصد خير لا بد وأن يسرف إن لم يذمه العلم المحقق وربما يقدم على ما يكون بدعة في الدين ليستضر الناس بعده بها وهو يظن أنه مشغول بالخير ولهذا قال صلى الله عليه وسلم فضل العالم على العابد كفضلي على أدنى رجل من أصحابي +

وقالت فرقة الوسوسة والذكر يتساوقان في الدوام على القلب تساوقا لا ينقطع وكما أن الإنسان قد يرى بعينيه شيئين في حالة واحدة فكذلك القلب قد يكون مجرى لشيئين فقد قال صلى الله عليه وسلم ما من عبد إلا وله أربعة أعين عينان في رأسه يبصر بهما أمر دنياه وعينان في قلبه يبصر بهما أمر دينه + حديث ما من عبد إلا وله أربعة أعين عينان في رأسه يبصر بهما أمر دنياه وعينان في قلبه يبصر بهما أمر دينه أخرجه أبو منصور الديلمي في مسند الفردوس من حديث معاذ بلفظ الآخرة مكان دينه وفيه الحسين بن أحمد بن محمد الهروي السماخي الحافظ كذبه الحاكم والآفة منه وإلى هذا ذهب المحاسبي والصحيح عندنا أن كل هذه المذاهب صحيحة ولكن كلها قاصرة عن الإحاطة بأصناف الوسواس وإنما نظر كل واحد منهم إلى صنف واحد من الوسواس فأخبر عنه

Etiology of obsessions and compulsions: a meta-analysis and narrative review of twin studies.: The relative importance of genetic and environmental factors in the etiology of obsessive-compulsive (OC) symptoms is unclear. Cognitive-behavioral models propose that shared environment (e.g., parenting style) is important. Family segregation studies suggest that nonadditive genetic factors may be involved. To investigate the etiology of OC symptoms, a meta-analysis was conducted of 37 twin samples from 14 studies, supplemented by a narrative review. Results indicated that in terms of mean effe

Is cyberchondria a new transdiagnostic digital compulsive syndrome? A systematic review of the evidence.: Background: Cyberchondria (CYB) has been described relatively recently as a behaviour characterized by excessive online searching for medical information that is associated with increasing levels of health anxiety. Although CYB has received some attention from researchers, there is no consensus about many of its aspects. Aims: We describe one of the first reported cases of a treatment-seeking patient with CYB. We review the published literature on the definition of CYB, its assessment, epidemiol

Family and couple integrated cognitive-behavioural therapy for adults with OCD: A meta-analysis.: Background: Integrating family into the treatment of obsessive-compulsive disorder (OCD) is standard in pediatric populations; however, in adult populations, patients are typically treated independent of their family. Yet, there is compelling evidence to suggest that family members exacerbate OCD symptoms, and thus there is a strong rationale for integrating family members into the treatment of adult OCD. The present meta-analysis examined whether family treatment is effective for OCD in adult p

Effects of exercise on obsessive-compulsive disorder symptoms: a systematic review and meta-analysis.: Objective: This systematic review and meta-analysis assessed the efficacy of exercise in reducing OCD symptoms. Methods: We searched PubMed, Cochrane Central Register of Controlled Trials, MEDLINE, Scopus and grey literature until March 2022. The study was preregistered at Prospero (CRD42021283931). We included randomised controlled and pre-post trials assessing physical activity as an intervention for OCD. Risk of bias was assessed using the Cochrane ROBINS-I tool and the RoB2 tool. Results: Th

Associations between perfectionism and symptoms of anxiety, obsessive-compulsive disorder and depression in young people: a meta-analysis.: Perfectionism is a transdiagnostic process contributing to the onset and maintenance of anxiety, obsessive-compulsive disorder (OCD) and depression. The aim of this systematic review and meta-analysis was to examine the association between perfectionism, and symptoms of anxiety, OCD and depression among young people aged 6-24 years. A systematic literature search retrieved a total of 4,927 articles, with 121 studies included (Mpooled age = ~17.70 years). Perfectionistic concerns demonstrated sig

Distinct Subcortical Volume Alterations in Pediatric and Adult OCD: A Worldwide Meta- and Mega-Analysis.: Objective: Structural brain imaging studies in obsessive-compulsive disorder (OCD) have produced inconsistent findings. This may be partially due to limited statistical power from relatively small samples and clinical heterogeneity related to variation in illness profile and developmental stage. To address these limitations, the authors conducted meta- and mega-analyses of data from OCD sites worldwide. Method: T1 images from 1,830 OCD patients and 1,759 control subjects were analyzed, using coo

Development and assessment of brief versions of the Penn State Worry Questionnaire and the Ruminative Response Scale.

Objectives: Worry and depressive rumination have been found to be involved in the onset and maintenance of a range of psychological disorders. The development of brief screening measures for excessive worry and depressive rumination is therefore desirable to facilitate the assessment of worry and rumination in prevention and treatment settings where routine administration of full questionnaires is not practical due to time-related constraints. Design and methods: Using the Penn State Worry Questionnaire (PSWQ) and the Ruminative Response Scale (RRS) as gold standard starting points, brief versions of these measures were developed in a large sample of adolescents (N = 1,952) and results were cross-validated in two independent samples (N = 1,954; N = 457). Results: The brief versions demonstrated acceptable to high internal consistency (brief PSWQ: α = .84-.91; brief RRS: α = .78-.81) and …

matched on Obsessive-Compulsive Disorder (mesh)

Natural recovery and treatment-seeking in pathological gambling: results of two U.S. national surveys.

Objective: Pathological gambling is described in DSM-IV as a chronic and persisting disorder, but recent community-based longitudinal studies that have highlighted the transitory nature of gambling-related problems have called into question whether this is an accurate characterization. This emerging evidence of high rates of recovery coupled with low rates of treatment-seeking for pathological gambling suggests that natural recovery might be common. The purpose of the present study was to document the rates of recovery, treatment-seeking, and natural recovery among individuals with DSM-IV pathological gambling disorder in two large and representative U.S. national surveys. Method: Prevalences of recovery, treatment-seeking, and natural recovery were estimated among individuals from the Gambling Impact and Behavior Study (N=2,417) and the National Epidemiologic Survey on Alcohol and Relat…

matched on Obsessive-Compulsive Disorder (mesh)

Psilocybin with psychological support for treatment-resistant depression: an open-label feasibility study.

Background: Psilocybin is a serotonin receptor agonist that occurs naturally in some mushroom species. Recent studies have assessed the therapeutic potential of psilocybin for various conditions, including end-of-life anxiety, obsessive-compulsive disorder, and smoking and alcohol dependence, with promising preliminary results. Here, we aimed to investigate the feasibility, safety, and efficacy of psilocybin in patients with unipolar treatment-resistant depression. Methods: In this open-label feasibility trial, 12 patients (six men, six women) with moderate-to-severe, unipolar, treatment-resistant major depression received two oral doses of psilocybin (10 mg and 25 mg, 7 days apart) in a supportive setting. There was no control group. Psychological support was provided before, during, and after each session. The primary outcome measure for feasibility was patient-reported intensity of ps…

matched on obsessive-compulsive (text), compulsions (text)

Psychopathology in the offspring of parents with bipolar disorder: a controlled study.

Background: To examine the risk for psychopathology in offspring at risk for bipolar disorder and the course of psychiatric disorders in these youth. Methods: Using structured diagnostic interviews (Structured Clinical Interview for DSM-IV [SCID] and Kiddie Schedule for Affective Disorders and Schizophrenia [K-SADS]), psychiatric diagnoses of 117 nonreferred offspring of parents with diagnosed bipolar disorder were compared with those of 171 age- and gender-matched offspring of parents without bipolar disorder or major depression. Results: Compared with offspring of parents without mood disorders, high-risk youth had elevated rates of major depression and bipolar disorder, anxiety, and disruptive behavior disorders. High-risk offspring also had significantly more impaired Global Assessment of Functioning (GAF) scores, higher rates of psychiatric treatment, and higher rates of placement i…

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Persistence, perseveration and perfectionism in the eating disorders.

Background: Perseveration, persistence and perfectionism are traits that have been suggested to be relevant to the eating disorders. This study explored the levels and correlates of these three traits in the eating disorders and control groups. Method: A measure of these three elements (the Persistence, Perseveration and Perfectionism Questionnaire - PPPQ-22) was administered to 99 women with eating disorders, 25 women with other psychiatric disorders, and 91 non-clinical women. Differences in PPPQ-22 scores across groups were measured, as were the associations between PPPQ-22 scores and eating attitudes. Results: The eating disordered groups showed lower levels of persistence (the drive towards goal achievement) than the non-clinical group, but did not show higher levels of perseveration (the following of rules, without considering whether goals are achieved). Both women with eating dis…

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Prevalence and correlates of clinically significant body-focused repetitive behaviors in a non-clinical sample.

Background: Body-focused repetitive behaviors (BFRBs) are repetitive, ritualized behaviors focused on the body, involving compulsively damaging one's physical appearance or causing physical injury. They include skin picking, hair pulling, nail biting, and lip or cheek biting and chewing. This study sought to examine prevalence, clinical correlates and quality of life (QoL) impairment associated with these conditions in a non-clinical sample of adults. Method: An online survey was completed by N = 1378 participants. Comparisons were made between those self-reporting body-focused repetitive behavior to those without, on a range of clinical correlates (depression, anxiety, obsessive-compulsive symptoms, body dysmorphic symptoms, fear of negative evaluation) and QoL domains. Results: Three-hundred and eighteen participants (23%) reported the presence of a probable BFRB; n = 85 (6%) nail biti…

matched on Obsessive-Compulsive Disorder (mesh), Compulsive Behavior (mesh), obsessive-compulsive (text), compulsions (text)

Mindfulness-based cognitive therapy as an augmentation treatment for obsessive-compulsive disorder.

A significant number of obsessive-compulsive disorder (OCD) patients continue to experience symptoms that interfere with their functioning following cognitive behavioural therapy (CBT). Providing an additional augmentation treatment following CBT could help reduce these residual symptoms. Mindfulness interventions that facilitate less reactivity to thoughts and feelings may be helpful for patients suffering from residual OCD symptoms. The purpose of the current randomized waitlist control trial was to evaluate the feasibility and impact of providing an 8-week mindfulness-based cognitive therapy (MBCT) intervention following completion of a CBT intervention to OCD patients who continued to suffer from significant symptoms. Results indicated that compared to the waitlist control group, MBCT participants reported decreases in OCD symptoms (d = 1.38), depression symptoms (d = 1.25), anxiety …

matched on Obsessive-Compulsive Disorder (mesh), Obsessive-Compulsive Disorder (keyword), obsessive-compulsive (text), compulsions (text), intrusive thoughts (text)

Imbalance in habitual versus goal directed neural systems during symptom provocation in obsessive-compulsive disorder.

Intrusive thoughts and compulsive urges to perform stereotyped behaviours are typical symptoms of obsessive-compulsive disorder. Emerging evidence suggests a cognitive bias towards habit formation at the expense of goal-directed performance in obsessive-compulsive disorder. In this study, we test this hypothesis using a novel individualized ecologically valid symptom provocation design: a live provocation functional magnetic resonance imaging paradigm with synchronous video-recording of behavioural avoidance responses. By pairing symptom provocation with online avoidance responses on a trial-by-trial basis, we sought to investigate the neural mechanisms leading to the compulsive avoidance response. In keeping with the model of habit formation in obsessive-compulsive disorder, we hypothesized that this disorder would be associated with lower activity in regions implicated in goal-directed…

matched on Obsessive-Compulsive Disorder (mesh), Obsessive-Compulsive Disorder (keyword), obsessive-compulsive (text), compulsions (text), intrusive thoughts (text)

Decreased limbic and increased fronto-parietal connectivity in unmedicated patients with obsessive-compulsive disorder.

Obsessive-compulsive disorder (OCD) is characterized by recurrent intrusive thoughts and ritualized, repetitive behaviors, or mental acts. Convergent experimental evidence from neuroimaging and neuropsychological studies supports an orbitofronto-striato-thalamo-cortical dysfunction in OCD. Moreover, an over excitability of the amygdala and over monitoring of thoughts and actions involving the anterior cingulate, frontal and parietal cortex has been proposed as aspects of pathophysiology in OCD. We chose a data driven, graph theoretical approach to investigate brain network organization in 17 unmedicated OCD patients and 19 controls using resting-state fMRI. OCD patients showed a decreased connectivity of the limbic network to several other brain networks: the basal ganglia network, the default mode network, and the executive/attention network. The connectivity within the limbic network w…

matched on Obsessive-Compulsive Disorder (mesh), Obsessive-Compulsive Disorder (keyword), obsessive-compulsive (text), compulsions (text), intrusive thoughts (text)

Five-year course of obsessive-compulsive disorder: predictors of remission and relapse.

Background: Obsessive-compulsive disorder (OCD) is a heterogeneous and disabling condition; however, no studies have examined symptom categories or subtypes as predictors of long-term clinical course in adults with primary OCD. Method: A total of 213 adults with DSM-IV OCD were recruited from several mental health treatment sites between July 2001 and February 2006 as part of the Brown Longitudinal Obsessive Compulsive Study, a prospective, naturalistic study of treatment-seeking adults with primary OCD. OCD symptoms were assessed annually over the 5-year follow-up period using the Longitudinal Interval Follow-Up Evaluation. Results: Thirty-nine percent of participants experienced either a partial (22.1%) or a full (16.9%) remission. Two OCD symptom dimensions impacted remission. Participants with primary obsessions regarding overresponsibility for harm were nearly twice as likely to exp…

matched on Obsessive-Compulsive Disorder (mesh), Compulsive Behavior (mesh), obsessive-compulsive (text), compulsions (text)

Postpartum obsessive-compulsive disorder: prevalence and clinical characteristics.

Objective: The principal aims of this study were to examine the prevalence rate, clinical characteristics, and related factors of postpartum obsessive-compulsive disorder (OCD). Method: The subjects were a nonclinical sample of 400 postpartum women. They were interviewed from the 2nd up to the 26th week after birth. The Mini International Neuropsychiatric Interview was used for diagnosis of OCD, the Yale-Brown Obsessive-Compulsive Symptom Checklist was used to determine the types of obsessions and compulsions, and the Structured Clinical Interview for DSM-IV Axis I Disorders was used to diagnose comorbid depressive episode. Results: Thirty-six (9%) of the sample met the diagnostic criteria for OCD according to the Mini International Neuropsychiatric Interview, and 9 (2.3%) reported postpartum onset OCD. Obsessive-compulsive disorder was more frequent in mothers with personal history of p…

matched on Obsessive-Compulsive Disorder (mesh), Compulsive Behavior (mesh), obsessive-compulsive (text), compulsions (text)

An experimental analysis of hypochondriasis.

Hypochondriasis (HC) involves preoccupation with fears of having a serious medical illness based on the misinterpretation of benign bodily perturbations. Individuals with HC also perform behaviors such as checking and reassurance-seeking presumably to reduce health-related fears. Experimental behavioral analyses of HC symptoms, however, are lacking. In the present study, 27 patients with HC were exposed to personally relevant health-related stimuli under one of two conditions: (a) subsequently performing safety-seeking behaviors (e.g., checking) (n=14) or (b) subsequently being instructed not to perform such behaviors (n=13). In both groups, subjective anxiety and urges to perform safety behaviors were monitored for 1h. Results indicated that exposure to the personally relevant health trigger provoked anxiety and urges to perform safety behaviors. For patients who performed such behavior…

matched on Obsessive-Compulsive Disorder (mesh), Compulsive Behavior (mesh), obsessive-compulsive (text), compulsions (text)

Treatment resistance in psychiatry: state of the art and new directions.

Treatment resistance affects 20-60% of patients with psychiatric disorders; and is associated with increased healthcare burden and costs up to ten-fold higher relative to patients in general. Whilst there has been a recent increase in the proportion of psychiatric research focussing on treatment resistance (R2 = 0.71, p < 0.0001), in absolute terms this is less than 1% of the total output and grossly out of proportion to its prevalence and impact. Here, we provide an overview of treatment resistance, considering its conceptualisation, assessment, epidemiology, impact, and common neurobiological models. We also review new treatments in development and future directions. We identify 23 consensus guidelines on its definition, covering schizophrenia, major depressive disorder, bipolar affective disorder, and obsessive compulsive disorder (OCD). This shows three core components to its definit…

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Mapping Compulsivity in the DSM-5 Obsessive Compulsive and Related Disorders: Cognitive Domains, Neural Circuitry, and Treatment.

Compulsions are repetitive, stereotyped thoughts and behaviors designed to reduce harm. Growing evidence suggests that the neurocognitive mechanisms mediating behavioral inhibition (motor inhibition, cognitive inflexibility) reversal learning and habit formation (shift from goal-directed to habitual responding) contribute toward compulsive activity in a broad range of disorders. In obsessive compulsive disorder, distributed network perturbation appears focused around the prefrontal cortex, caudate, putamen, and associated neuro-circuitry. Obsessive compulsive disorder-related attentional set-shifting deficits correlated with reduced resting state functional connectivity between the dorsal caudate and the ventrolateral prefrontal cortex on neuroimaging. In contrast, experimental provocation of obsessive compulsive disorder symptoms reduced neural activation in brain regions implicated in …

matched on Obsessive-Compulsive Disorder (mesh), compulsions (text)

Components of Cognitive Behavioral Therapy Related to Outcome in Childhood Anxiety Disorders.

The present article uses meta-analysis to examine treatment components related to outcome within 35 randomized controlled trials (RCTs) for childhood anxiety disorders (CADs) and eight RCTs for childhood obsessive compulsive disorder (OCD). Examination of the RCTs of cognitive behavioral therapy (CBT) for CADs suggested that adding relaxation and delaying exposures until after the introduction of other anxiety management strategies does not increase the efficacy of exposure-based treatment. In addition, compared to the large effect size (ES) associated with exposure and response prevention (ERP) for OCD (k = 9, mean ES = 1.93), the effect size associated with CBT for CADs (k = 44, mean ES = 0.89) did not differentiate from attention placebo (k = 11, mean ES = 0.55), although it was more effective than waitlist control (k = 24, mean ES = 0.22). Instructively, ERP for OCD involved more exp…

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Neuroinflammatory pathways in anxiety, posttraumatic stress, and obsessive compulsive disorders.

As prevalence of anxiety, posttraumatic stress, and obsessive compulsive disorders continue to rise worldwide, increasing focus has been placed on immune mediated theories in understanding the underlying mechanisms of these disorders. Associations between the dysregulation of the hypothalamic-pituitary-adrenal (HPA) axis and these disorders have been recognized in the scientific literature, specifically in regard to cortisol levels, as well as changes in pro- and anti-inflammatory cytokines. The present commentary will systematically assess the scientific literature within the past decade in regard to the psychoneuroimmunology of anxiety, posttraumatic stress, and obsessive compulsive disorders. Understanding the mechanisms of these disorders is essential in order to determine efficacious and targeted treatment strategies, which may lead to substantial improvements in overall functioning…

matched on Obsessive-Compulsive Disorder (mesh), compulsions (text)

Minnesota Impulse Disorders Interview (MIDI): Validation of a structured diagnostic clinical interview for impulse control disorders in an enriched community sample.

Background: Disorders of impulsivity are common, functionally impairing, and highly relevant across different clinical and research settings. Few structured clinical interviews for the identification and diagnosis of impulse control disorders exist, and none have been validated in a community sample in terms of psychometric properties. Methods: The Minnesota Impulse control disorders Interview (MIDI v2.0) was administered to an enriched sample of 293 non-treatment seeking adults aged 18-35 years, recruited using media advertisements in two large US cities. In addition to the MIDI, participants undertook extended clinical interview for other mental disorders, the Barratt impulsiveness questionnaire, and the Padua obsessive-compulsive inventory. The psychometric properties of the MIDI were characterized. Results: In logistic regression, the MIDI showed good concurrent validity against the …

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Aetiological overlap between anxiety and attention deficit hyperactivity symptom dimensions in adolescence.

Background: Anxiety and attention-deficit/hyperactivity (ADH) problems are common in adolescence, often co-occur, and are characterised by high heterogeneity in their phenotypic expressions. Although it is known that anxiety and ADH problems correlate, the relationships between subtypes of anxiety and ADH problems have been scarcely investigated. Methods: Using a large population sample of adolescent twins and siblings we explored the phenotypic and aetiological association between anxiety subtypes (panic/agoraphobia, separation anxiety, social anxiety, physical injury fears, obsessive-compulsive symptoms and generalised anxiety) and the two ADH dimensions (attention problems and hyperactivity/impulsivity). Both phenotypes were assessed using self-report questionnaires. Results: The association between ADH problems and anxiety could be entirely attributed to attention problems, not hyper…

matched on obsessive-compulsive (text), compulsions (text)

Personality-based subtypes of anorexia nervosa: examining validity and utility using baseline clinical variables and ecological momentary assessment.

Objective: This study sought to empirically derive and validate clinically relevant personality-based subtypes of anorexia nervosa (AN). Methods: Women (N = 116) with full or subthreshold AN completed baseline measures of personality, clinical variables, and eating disorder (ED) symptoms, followed by two weeks of ecological momentary assessment (EMA). A latent profile analysis was conducted to identify personality subtypes, which were compared on baseline clinical variables and EMA variables. Results: The best-fitting model supported three subtypes: underregulated, overregulated, and low psychopathology. The underregulated subtype (characterized by high Stimulus Seeking, Self-Harm, and Oppositionality) displayed greater baseline ED symptoms, as well as lower positive affect and greater negative affect, self-discrepancy, and binge eating in the natural environment. The overregulated subty…

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Psychological distress in adult survivors of childhood cancer: the Swiss Childhood Cancer Survivor study.

Purpose: To evaluate the degree of psychological distress in adult childhood cancer survivors in Switzerland and to characterize survivors with significant distress. Methods: Childhood cancer survivors who were age younger than 16 years when diagnosed between 1976 and 2003, had survived more than 5 years, and were currently age 20 years or older received a postal questionnaire. Psychological distress was assessed using the Brief Symptom Inventory (BSI). Raw scores were transformed into T scores according to the German norm sample, and the proportion of participants being at increased risk for psychological distress was calculated (case rule: T > or = 63). t tests and univariable and multivariable logistic regressions were used for statistical analyses. Results: One thousand seventy-six survivors (63.% of eligible survivors, 71.9% of contacted survivors) returned the questionnaire, 987 wi…

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Pain-related anxiety and anxiety sensitivity across anxiety and depressive disorders.

Fear-anxiety-avoidance models posit pain-related anxiety and anxiety sensitivity as important contributing variables in the development and maintenance of chronic musculoskeletal pain [Asmundson, G. J. G, Vlaeyen, J. W. S., & Crombez, G. (Eds.). (2004). Understanding and treating fear of pain. New York: Oxford University Press]. Emerging evidence also suggests that pain-related anxiety may be a diathesis for many other emotional disorders [Asmundson, G. J. G., & Carleton, R. N. (2005). Fear of pain is elevated in adults with co-occurring trauma-related stress and social anxiety symptoms. Cognitive Behaviour Therapy, 34, 248-255; Asmundson, G. J. G., & Carleton, R. N. (2008). Fear of pain. In: M. M. Antony & M. B. Stein (Eds.), Handbook of anxiety and the anxiety disorders (pp. 551-561). New York: Oxford University Press] and appears to share several elements in common with other fears (e…

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Structure of genetic and environmental risk factors for dimensional representations of DSM-IV anxiety disorders.

Background: Twin data permit decomposition of comorbidity into genetically and environmentally derived correlations. No previous twin study includes all major forms of anxiety disorder. Aims: To estimate the degree to which genetic and environmental risk factors are shared rather than unique to dimensionally scored panic disorder, generalised anxiety disorder, phobias, obsessive-compulsive disorder and post-traumatic stress disorder. Method: Data obtained from 2801 young-adult Norwegian twins by means of the Composite International Diagnostic Interview were analysed with the Mx program. Results: A multivariate common factor model fitted best. The latent liability to all anxiety disorders was substantially more heritable (54%) than the individual disorders (23% to 40%). Most of the genetic effect was common to the disorders. Genes contributed just over 50% to the covariance between liabil…

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Paroxetine: safety and tolerability issues.

Paroxetine is a selective serotonin re-uptake inhibitor (SSRI) available in immediate release and controlled release (CR) formulations. Paroxetine is the most potent inhibitor of serotonin re-uptake among the now available SSRIs. Paroxetine has been approved for the treatment of major depressive disorder (MDD), obsessive-compulsive disorder, panic disorder (PD), generalised anxiety disorder, post traumatic stress disorder (PTSD), and social anxiety disorder (SAD) in adults, whereas paroxetine CR is approved for the treatment of MDD, SAD, PD and premenstrual dysphoric disorder in adults. The overall efficacy of paroxetine seems to be comparable to other SSRIs in the treatment of approved indications, although paroxetine treatment induces more sedation, constipation, sexual dysfunction, discontinuation syndrome and weight gain than other SSRIs. Recent data suggest that paroxetine treatment…

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The economic burden of personality disorders in mental health care.

Objective: Some evidence suggests that personality disorders are associated with a high economic burden due to, for example, a high demand on psychiatric, health, and social care services. However, state-of-the-art cost studies for the broad range of personality disorder diagnoses are lacking. The present study examines the direct medical costs, as well as the indirect costs, of patients seeking mental health treatment with DSM-IV personality disorders. Method: The 1740 subjects included in this study were recruited from March 2003 to March 2006 from 6 different mental health care institutes in the Netherlands specializing in the psychotherapeutic treatment of personality disorders. The direct and indirect costs were assessed using the Trimbos and Institute for Medical Technology Assessment Questionnaire on Costs Associated with Psychiatric Illness. Personality disorders were diagnosed u…

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Factor structure, reliability and criterion validity of the Autism-Spectrum Quotient (AQ): a study in Dutch population and patient groups.

The factor structure of the Dutch translation of the Autism-Spectrum Quotient (AQ; a continuous, quantitative measure of autistic traits) was evaluated with confirmatory factor analyses in a large general population and student sample. The criterion validity of the AQ was examined in three matched patient groups (autism spectrum conditions (ASC), social anxiety disorder, and obsessive-compulsive disorder). A two factor model, consisting of a "Social interaction" factor and "Attention to detail" factor could be identified. The internal consistency and test-retest reliability of the AQ were satisfactory. High total AQ and factor scores were specific to ASC patients. Men scored higher than women and science students higher than non-science students. The Dutch translation of the AQ is a reliable instrument to assess autism spectrum conditions.

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