Declaration of interest: None.
Funding: The Dunedin Multidisciplinary Health and Development Research Unit is supported by the New Zealand Health Research Council. This research was supported by grants from the US National Institute of Mental Health (MH 45070, MH49414), the UK Medical Research Council grant G0100527, and a Postdoctoral Fellowship with the School of Psychiatry, University of New South Wales.
Background: Existing neuropsychological studies of obsessive-compulsive disorder (OCD) are cross-sectional and do not provide evidence of whether deficits are trait-related (antecedent and independent of symptomatology) or state-related (a consequence, dependent on symptomatology).
Aims: To investigate whether there are premorbid neuropsychological deficits associated with adult OCD.
Method: Longitudinal data were collected from participants of the Dunedin Multidisciplinary Health and Developmental study. Neuropsychological data collected at age 13 were linked with age 32 diagnosis of OCD.
Results: The group who had OCD at age 32 differed significantly from the control group with no OCD on their performance at age 13 on neuropsychological tests of visuospatial, visuoconstructive and visuomotor skills, controlling for gender and socioeconomic status, but did not differ on tests of general IQ or verbal ability. Performance of the group with OCD on tests of executive functioning was mixed.
Conclusions: Individuals with OCD have premorbid impairment in visuospatial abilities and some forms of executive functioning, consistent with biological models of OCD.
© 2009 The Royal College of Psychiatrists
DBS for OCD: Reviewing the Evidence and Proceeding with Care
Goodman WK.
Department of Psychiatry, Mount Sinai School of Medicine
Introduction
Deep brain stimulation (DBS) and vagus nerve stimulation (VNS) are well known, though uncommonly used, treatments for several neurological and psychiatric disorders. Many of the reasons for the limited use of these novel, devise-based treatments concern their invasiveness, of course. Dr Wayne K. Goodman, a leading OCD researcher, explains the most important similarities and differences between these two treatments: “VNS and DBS are both interventions aimed at modulating activity in the brain. They both involve surgery. DBS is more invasive and involves greater risks, because, in contrast to VNS, it requires one or two bore holes in the cranium and direct implantation to the brain. With VNS, the operation is performed on the neck to get access to an ascending branch of the vagus nerve and wrap it with an electrode.“
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© 2009 Psychiatry Weekly, LLC
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