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

Chronic dopaminergic stimulation in Parkinson's disease: from dyskinesias to impulse control disorders.

Dopamine is an essential neurotransmitter for many brain functions, and its dysfunction has been implicated in both neurological and psychiatric disorders. Parkinson's disease is an archetypal disorder of dopamine dysfunction characterised by motor, cognitive, behavioural, and autonomic symptoms. While effective for motor symptoms, dopamine replacement therapy is associated not only with motor side-effects, such as levodopa-induced dyskinesia, but also behavioural side-effects such as impulse control disorders (eg, pathological gambling and shopping, binge eating, and hypersexuality), punding (ie, abnormal repetitive non-goal oriented behaviours), and compulsive medication use. We review clinical features, overlapping molecular mechanisms, and a specific cognitive mechanism of habit learning that might underlie these behaviours. We integrate these mechanisms with the emerging view of the…

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Review. Neural mechanisms underlying the vulnerability to develop compulsive drug-seeking habits and addiction.

We hypothesize that drug addiction can be viewed as the endpoint of a series of transitions from initial voluntary drug use through the loss of control over this behaviour, such that it becomes habitual and ultimately compulsive. We describe evidence that the switch from controlled to compulsive drug seeking represents a transition at the neural level from prefrontal cortical to striatal control over drug-seeking and drug-taking behaviours as well as a progression from ventral to more dorsal domains of the striatum, mediated by its serially interconnecting dopaminergic circuitry. These neural transitions depend upon the neuroplasticity induced by chronic self-administration of drugs in both cortical and striatal structures, including long-lasting changes that are the consequence of toxic drug effects. We further summarize evidence showing that impulsivity, a spontaneously occurring behav…

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The assessment of the family of people with eating disorders.

The National Institute for Clinical Excellence (NICE) guidelines for eating disorders recommend that carers should be provided with information and support and that their needs should be considered if relevant. The aim of this paper is to describe how to structure an assessment of carers needs so that the family factors that can contribute to the maintenance of eating disorder symptoms are examined. We describe in detail the pattern of interpersonal reactions that can result when a family member has an eating disorder. Shared traits such as anxiety, compulsivity and abnormal eating behaviours contribute to some of the misperceptions, misunderstandings and confusion about the meaning of the eating disorder for family members. Unhelpful attributions can fuel a variety of emotional reactions (criticism, hostility, overprotection, guilt and shame). Gradually these forces cause family members…

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Guidelines for the pharmacological treatment of anxiety disorders, obsessive–compulsive disorder and posttraumatic stress disorder in primary care

OBJECTIVE: Anxiety disorders are frequently under-diagnosed conditions in primary care, although they can be managed effectively by general practitioners. METHODS: This paper is a short and practical summary of the World Federation of Biological Psychiatry (WFSBP) guidelines for the pharmacological treatment of anxiety disorders, obsessive-compulsive disorder (OCD) and posttraumatic stress disorder (PTSD) for the treatment in primary care. The recommendations were developed by a task force of 30 international experts in the field and are based on randomized controlled studies. RESULTS: First-line pharmacological treatments for these disorders are selective serotonin reuptake inhibitors (for all disorders), serotonin-norepinephrine reuptake inhibitors (for some) and pregabalin (for generalized anxiety disorder only). A combination of medication and cognitive behavior/exposure therapy was …

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Clinical features of obsessive-compulsive disorder among individuals who experience health-related obsessive-compulsive symptoms.

Background: While some obsessive-compulsive disorder (OCD) phenotypes are well-established and better understood, it is unclear whether the presence of health-related obsessive-compulsive symptoms (OCS) is associated with specific clinical characteristics. We aimed to investigate whether OCS involving concerns with illness, diseases, body parts or aspects of appearance (i.e. health-related OCS) are associated with differences in demographics, experience of stressful life events, clinical severity, clinical course, endorsement of established OCD dimensions, and psychiatric comorbidities. Methods: Individuals (N = 1001) with a clinical diagnosis of OCD (M = 34.85, SD = 12.99) completed a questionnaire battery assessing clinical course (age at symptom onset, age at diagnosis, duration of illness), total and dimensional symptom severity, and psychiatric comorbidities. We ran initial univaria…

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Anxiety and depression in COVID-19 survivors: Role of inflammatory and clinical predictors.

Infection-triggered perturbation of the immune system could induce psychopathology, and psychiatric sequelae were observed after previous coronavirus outbreaks. The spreading of the Severe Acute Respiratory Syndrome Coronavirus (COVID-19) pandemic could be associated with psychiatric implications. We investigated the psychopathological impact of COVID-19 in survivors, also considering the effect of clinical and inflammatory predictors. We screened for psychiatric symptoms 402 adults surviving COVID-19 (265 male, mean age 58), at one month follow-up after hospital treatment. A clinical interview and a battery of self-report questionnaires were used to investigate post-traumatic stress disorder (PTSD), depression, anxiety, insomnia, and obsessive-compulsive (OC) symptomatology. We collected sociodemographic information, clinical data, baseline inflammatory markers and follow-up oxygen satu…

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Patterns of alpha asymmetry in those with elevated worry, trait anxiety, and obsessive-compulsive symptoms: A test of the worry and avoidance models of alpha asymmetry.

Some authors have argued that worry cues lateralization of frontal brain activity leftward, whereas other varieties of avoidance motivation cue lateralization of frontal brain activity rightward. By comparison, more right-than-left parietal activity correlates with anxious arousal. The purpose of the present report was to test two models of brain lateralization and anxiety: one model that proposed that worry correlates with more left-frontal activity and another model that proposed that avoidance motivation (including worry) correlates with more right-frontal activity. Undergraduate students were selected for worry, obsessive-compulsive symptoms, and trait anxiety using self-report questionnaires. A subset of participants also met DSM-IV criteria for Generalized Anxiety Disorder (GAD) or Obsessive-Compulsive Disorder (OCD). Alpha asymmetry and also a global-power-adjusted metric of alpha…

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Capacity to delay reward differentiates obsessive-compulsive disorder and obsessive-compulsive personality disorder.

Background: Although the relationship between obsessive-compulsive disorder (OCD) and obsessive-compulsive personality disorder (OCPD) has long been debated, clinical samples of OCD (without OCPD) and OCPD (without OCD) have never been systematically compared. We studied whether individuals with OCD, OCPD, or both conditions differ on symptomatology, functioning, and a measure of self-control: the capacity to delay reward. Methods: Twenty-five OCD, 25 OCPD, 25 comorbid OCD + OCPD, and 25 healthy control subjects completed clinical assessments and a validated intertemporal choice task that measures capacity to forego small immediate rewards for larger delayed rewards. Results: OCD and OCPD subjects both showed impairment in psychosocial functioning and quality of life, as well as compulsive behavior, but only subjects with OCD reported obsessions. Individuals with OCPD, with or without co…

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Enhanced avoidance habits in obsessive-compulsive disorder.

Background: Obsessive-compulsive disorder (OCD) is a psychiatric condition that typically manifests in compulsive urges to perform irrational or excessive avoidance behaviors. A recent account has suggested that compulsivity in OCD might arise from excessive stimulus-response habit formation, rendering behavior insensitive to goal value. We tested if OCD patients have a bias toward habits using a novel shock avoidance task. To explore how habits, as a putative model of compulsivity, might relate to obsessions and anxiety, we recorded measures of contingency knowledge, explicit fear, and physiological arousal. Methods: Twenty-five OCD patients and 25 control subjects completed a shock avoidance task designed to induce habits through overtraining, which were identified using goal-devaluation. The relationship between habitual behavior, erroneous cognitions, and physiological arousal was as…

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Counterfactual processing of economic action-outcome alternatives in obsessive-compulsive disorder: further evidence of impaired goal-directed behavior.

Background: Obsessive-compulsive disorder (OCD) is a disorder of automatic, uncontrollable behaviors and obsessive rumination. There is evidence that OCD patients have difficulties performing goal-directed actions, instead exhibiting repetitive stimulus-response habit behaviors. This might result from the excessive formation of stimulus-response habit associations or from an impairment in the ability to use outcome value to guide behavior. We investigated the latter by examining counterfactual decision making, which is the ability to use comparisons of prospective action-outcome scenarios to guide economic choice. Methods: We tested decision making (forward counterfactual) and affective responses (backward counterfactual) in 20 OCD patients and 20 matched healthy control subjects using an economic choice paradigm that previously revealed attenuation of both the experience and avoidance o…

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Evidence-based pharmacological treatment of anxiety disorders, post-traumatic stress disorder and obsessive-compulsive disorder: a revision of the 2005 guidelines from the British Association for Psychopharmacology.

This revision of the 2005 British Association for Psychopharmacology guidelines for the evidence-based pharmacological treatment of anxiety disorders provides an update on key steps in diagnosis and clinical management, including recognition, acute treatment, longer-term treatment, combination treatment, and further approaches for patients who have not responded to first-line interventions. A consensus meeting involving international experts in anxiety disorders reviewed the main subject areas and considered the strength of supporting evidence and its clinical implications. The guidelines are based on available evidence, were constructed after extensive feedback from participants, and are presented as recommendations to aid clinical decision-making in primary, secondary and tertiary medical care. They may also serve as a source of information for patients, their carers, and medicines man…

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The Comparison of Death Anxiety, Obsession, and Depression Between Muslim Population with Positive and Negative Religious Coping.

Death anxiety, obsession, and depression constitute three dimensions of death distress which can be influenced by religious coping in religious individuals. The aim of this study was to compare death anxiety, depression, and obsession between Muslims with positive and negative religious coping. In a cross-sectional study, a sample of 339 participants were selected via stratified random sampling method. The participants were screened using the Brief Religious Coping Scale, in which 60 individuals were identified to have positive religious coping and 62 individuals were recognized as individuals with negative religious coping. They responded to Death Anxiety Scale, Death Obsession Scale, and Death Depression Scale. The data were analyzed using factor analysis and multiple analysis of variance. The results of principal component analysis showed that death anxiety, death obsession, and death…

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Anger rumination, social support, and cardiac symptoms in patients undergoing angiography.

Objectives: Socially isolated individuals report more cardiac symptoms, suffer increased cardiovascular morbidity and mortality, and experience higher levels of stress and anxiety than those with more effective support resources. However, the complex interactions of psychosocial factors implicated in the disease process remain to be fully elucidated. We sought to explore these relationships, with the addition of a novel psychosocial variable, anger rumination, which could be associated with increased cardiovascular risk. Design: We examined the association of psychological stress, social support, and anger rumination, with surgical anxiety, self-reported cardiac symptoms, and angiographically documented coronary artery disease, using a correlational ex post facto design. Methods: One hundred and one patients scheduled for elective coronary angiography completed questionnaires during the …

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Multidimensional body image comparisons among patients with eating disorders, body dysmorphic disorder, and clinical controls: a multisite study.

Body image disturbance is considered a core characteristic of eating disorders and body dysmorphic disorder (BDD), however its definition has been unclear within the literature. This study examined the multidimensional nature of body image functioning among individuals with either anorexia nervosa (AN; n=35), bulimia nervosa (BN; n=26), or BDD (n=56), relative to female (n=34) and male (n=36) psychiatric controls. Participants were recruited from 10 treatment centers in the United States and England and completed psychometrically validated and standardized self-report measures of body image. Overall, the AN, BN, and BDD groups were characterized by significantly elevated disturbances in most body image dimensions relative to their gender-matched clinical controls. There was variability, however, in the comparisons among the three groups of interest, including foci of body dissatisfaction…

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Psychiatric Emergencies in Pregnancy and Postpartum.

The perinatal period is a vulnerable time for the acute onset and recurrence of psychiatric illness. Primary care providers are opportunely positioned to intervene for women who present with mood decompensation, excessive anxiety, or psychosis during the perinatal period. Owing to increased screening efforts in obstetrical clinics and amount of contact during the perinatal period, obstetricians may be able to identify patients who need treatment before their symptoms become severe. In this article, we address imminent and emergent psychiatric symptoms in the perinatal period including management and risk reduction to help obstetrician/gynecologists treat and/or refer patients as clinically appropriate.

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Psychedelics as Medicines: An Emerging New Paradigm.

Scientific interest in serotonergic psychedelics (e.g., psilocybin and LSD; 5-HT2A receptor agonists) has dramatically increased within the last decade. Clinical studies administering psychedelics with psychotherapy have shown preliminary evidence of robust efficacy in treating anxiety and depression, as well as addiction to tobacco and alcohol. Moreover, recent research has suggested that these compounds have potential efficacy against inflammatory diseases through novel mechanisms, with potential advantages over existing antiinflammatory agents. We propose that psychedelics exert therapeutic effects for psychiatric disorders by acutely destabilizing local brain network hubs and global network connectivity via amplification of neuronal avalanches, providing the occasion for brain network "resetting" after the acute effects have resolved. Antiinflammatory effects may hold promise for eff…

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Exercise and physical activity in mental disorders: clinical and experimental evidence.

Several epidemiological studies have shown that exercise (EX) and physical activity (PA) can prevent or delay the onset of different mental disorders, and have therapeutic benefits when used as sole or adjunct treatment in mental disorders. This review summarizes studies that used EX interventions in patients with anxiety, affective, eating, and substance use disorders, as well as schizophrenia and dementia/mild cognitive impairment. Despite several decades of clinical evidence with EX interventions, controlled studies are sparse in most disorder groups. Preliminary evidence suggests that PA/EX can induce improvements in physical, subjective and disorder-specific clinical outcomes. Potential mechanisms of action are discussed, as well as implications for psychiatric research and practice.

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Let's get physical: a contemporary review of the anxiolytic effects of exercise for anxiety and its disorders.

Research over the past few decades has focused on the therapeutic effects of physical exercise among those affected by mood disorders. Only recently has attention turned to maladaptive and persistent expressions of anxiety, with a growing body of evidence indicating promise for exercise as an effective treatment for some of the anxiety disorders. The current review provides a comprehensive account of contemporary research examining the anxiolytic effects of exercise for anxiety disorders. We synthesize pertinent research regarding the effects of various types of exercise within the different anxiety disorders, consider impact of various types of exercise regimens on anxiety, and examine potential anxiolytic mechanisms responsible for positive mental health gains. We conclude with important considerations for implementing exercise as a treatment for clinically significant anxiety as well …

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Health anxiety and hypochondriasis: Description and treatment issues highlighted through a case illustration.

Health anxiety and hypochondriasis are serious and debilitating conditions that are poorly understood by health care providers and general public. This is so partly because of the derogatory use of the term hypochondriasis by the general public. There has been a push by mental health professionals in recent years to use the term health anxiety and to use hypochondriasis only for its extreme form. The Internet has become a popular medium, through Web sites and chat rooms, for patients to seek information, reassurance, and exchange of medical information, sometimes of limited veracity. The term cyberchondria has even been coined to describe this phenomenon. The authors review the research literature related to health anxiety and discuss the beneficial treatments of CBT and pharmacology. The utilization of intensive cognitive-behavioral therapy is highlighted with a case illustration.

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Anxiety psychopathology in African American adults: literature review and development of an empirically informed sociocultural model.

In this review, the extant literature concerning anxiety psychopathology in African American adults is summarized to develop a testable, explanatory framework with implications for future research. The model was designed to account for purported lower rates of anxiety disorders in African Americans compared to European Americans, along with other ethnoracial differences reported in the literature. Three specific beliefs or attitudes related to the sociocultural experience of African Americans are identified: awareness of racism, stigma of mental illness, and salience of physical illnesses. In our model, we propose that these psychological processes influence interpretations and behaviors relevant to the expression of nonpathological anxiety as well as features of diagnosable anxiety conditions. Moreover, differences in these processes may explain the differential assessed rates of anxiet…

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Oxytocin and experimental therapeutics in autism spectrum disorders.

Autism is a developmental disorder characterized by three core symptom domains: speech and communication abnormalities, social functioning impairments and repetitive behaviours and restricted interests. Oxytocin (OXT) is a nine-amino-acid peptide that is synthesized in the paraventricular and supraoptic nucleus of the hypothalamus and released into the bloodstream by axon terminals in the posterior pituitary where it plays an important role in facilitating uterine contractions during parturition and in milk let-down. In addition, OXT and the structurally similar peptide arginine vasopressin (AVP) are released within the brain where they play a key role in regulating affiliative behaviours, including sexual behaviour, mother-infant and adult-adult pair-bond formation and social memory/recognition. Finally, OXT has been implicated in repetitive behaviours and stress reactivity. Given that …

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Epidemiology of the association between somatoform disorders and anxiety and depressive disorders: an update.

Objective: To review the available epidemiological evidence on associations between somatoform disorders with anxiety and depressive disorders. Results: Clinical and population-based studies have found that the co-occurrence of some types of somatoform disorders (e.g., somatization disorder, somatic-symptom-index (SSI)4,6, and pain disorder) and anxiety and depressive disorders is common. These findings may suggest either a causal relationship between these disorders or that they share some common etiological factors. For other forms of somatoform disorders, empirical evidence about co-occurrence is even thinner or not available at all, especially from non-western settings. Conclusion: Some implications of how these findings, or the absence of them, can help us understand better the etiology of somatoform disorders and improve the classification of mental disorders as a whole are discuss…

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Enhancing exposure-based therapy from a translational research perspective.

Combining an effective psychological treatment with conventional anxiolytic medication is typically not more effective than unimodal therapy for treating anxiety disorders. However, recent advances in the neuroscience of fear reduction have led to novel approaches for combining psychological therapy and pharmacological agents. Exposure-based treatments in humans partly rely on extinction to reduce the fear response in anxiety disorders. Animal studies have shown that D-cycloserine (DCS), a partial agonist at the glycine recognition site of the glutamatergic N-methyl-D-aspartate receptor facilitates extinction learning. Similarly, recent human trials have shown that DCS enhances fear reduction during exposure therapy of some anxiety disorders. This article discusses the biological and psychological mechanisms of extinction learning and the therapeutic value of DCS as an augmentation strat…

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Scrupulosity, Religious Affiliation and Symptom Presentation in Obsessive Compulsive Disorder.

Background: Scrupulosity is a common yet understudied presentation of obsessive compulsive disorder (OCD) that is characterized by obsessions and compulsions focused on religion. Despite the clinical relevance of scrupulosity to some presentations of OCD, little is known about the association between scrupulosity and symptom severity across religious groups. Aims: The present study examined the relationship between (a) religious affiliation and OCD symptoms, (b) religious affiliation and scrupulosity, and (c) scrupulosity and OCD symptoms across religious affiliations. Method: One-way ANOVAs, Pearson correlations and regression-based moderation analyses were conducted to evaluate these relationships in 180 treatment-seeking adults with OCD who completed measures of scrupulosity and OCD symptom severity. Results: Scrupulosity, but not OCD symptoms in general, differed across religious aff…

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Exploring predictors of aggressive intrusive thoughts and aggressive scripts: Similarities and differences in phenomenology.

Experiencing a thought about harming or injuring another person is commonly reported by the general population. Aggressive intrusive thoughts (AITs) and aggressive scripts are two constructs commonly used to define the experience of thinking about harming another person. However, they are generally investigated separately and with two significantly different population groups; respectively, individuals with obsessive-compulsive disorder and people with a history of violent behavior. AITs and aggressive scripts are assumed to have very different implications for violence risk assessment, but conceptual overlap and an absence of empirical research renders this assumption premature. Using a battery of self-report measures, this study aimed to investigate the differential predictors of AITs and aggressive script rehearsal in a nonclinical sample. Additionally, using regression analyses, the …

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