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dc.contributor.authorKashyap, Himani-
dc.contributor.authorFontenelle, Leonardo F.-
dc.contributor.authorMiguel, Euripedes C.-
dc.contributor.authorFerrão, Ygor A.-
dc.contributor.authorTorres, Albina Rodrigues-
dc.contributor.authorShavitt, Roseli G.-
dc.contributor.authorFerreira-Garcia, Rafael-
dc.contributor.authorDo Rosário, Maria C.-
dc.contributor.authorYücel, Murat-
dc.identifier.citationJournal of Psychiatric Research, v. 46, n. 9, p. 1146-1152, 2012.-
dc.description.abstractAlthough traditionally obsessive-compulsive disorder (OCD) and impulse control disorders (ICD) have represented opposing ends of a continuum, recent research has demonstrated a frequent co-occurrence of impulsive and compulsive behaviours, which may contribute to a worse clinical picture of some psychiatric disorders. We hypothesize that individuals with 'impulsive' OCD as characterized by poor insight, low resistance, and reduced control towards their compulsions will have a deteriorative course, greater severity of hoarding and/or symmetry/ordering symptoms, and comorbid ICD and/or substance use disorders (SUD). The sample consisted of 869 individuals with a minimum score of 16 on the Yale-Brown Obsessive Compulsive Scale (Y-BOCS). Of these, 65 had poor insight, low resistance, and reduced control towards compulsions ('poor IRC') and 444 had preserved insight, greater resistance and better control over compulsions ('good IRC'). These two groups were compared on a number of clinical and demographic variables. Individuals with poor IRC were significantly more likely to have a deteriorative course (p < 0.001), longer duration of obsessions (p = 0.017), greater severity of symmetry/ordering (p < 0.001), contamination/cleaning (p < 0.001) and hoarding (p = 0.002) symptoms, and comorbid intermittent explosive disorder (p = 0.026), trichotillomania (p = 0.014) and compulsive buying (p = 0.040). Regression analysis revealed that duration of obsessions (p = 0.037) and hoarding severity (p = 0.005) were significant predictors of poor IRC. In the absence of specific measures for impulsivity in OCD, the study highlights the utility of simple measures such as insight, resistance and control over compulsions as a phenotypic marker of a subgroup of OCD with impulsive features demonstrating poor clinical outcome. © 2012 Elsevier Ltd.en
dc.subjectImpulse control disorders-
dc.subjectImpulsive-compulsive spectrum-
dc.subjectInsight and resistance-
dc.subjectObsessive-compulsive disorder-
dc.subjectdisease duration-
dc.subjectimpulse control disorder-
dc.subjectmajor clinical study-
dc.subjectobsessive compulsive disorder-
dc.subjectpriority journal-
dc.subjectYale Brown Obsessive Compulsive Scale-
dc.subjectImpulse Control Disorders-
dc.subjectMiddle Aged-
dc.subjectObsessive-Compulsive Disorder-
dc.subjectPsychiatric Status Rating Scales-
dc.subjectRetrospective Studies-
dc.subjectSeverity of Illness Index-
dc.subjectStatistics, Nonparametric-
dc.subjectYoung Adult-
dc.titleImpulsive compulsivity in obsessive-compulsive disorder: A phenotypic marker of patients with poor clinical outcomeen
dc.contributor.institutionUniversity of Melbourne and Melbourne Health-
dc.contributor.institutionFederal University of Rio de Janeiro-
dc.contributor.institutionD'Or Institute for Research and Education-
dc.contributor.institutionUniversidade de São Paulo (USP)-
dc.contributor.institutionHealth Sciences Federal University of Porto Alegre-
dc.contributor.institutionUniversidade Estadual Paulista (UNESP)-
dc.description.affiliationMelbourne Neuropsychiatry Centre Department of Psychiatry University of Melbourne and Melbourne Health-
dc.description.affiliationAnxiety and Depression Research Program Institute of Psychiatry Federal University of Rio de Janeiro-
dc.description.affiliationD'Or Institute for Research and Education, Rio de Janeiro-
dc.description.affiliationDepartment of Psychiatry University of São Paulo Medical School-
dc.description.affiliationDepartment of Psychiatry Health Sciences Federal University of Porto Alegre-
dc.description.affiliationDepartment of Neurology, Psychology and Psychiatry Botucatu Medical School Universidade Estadual Paulista-
dc.description.affiliationDepartment of Psychiatry Federal University of São Paulo-
dc.description.affiliationUnespDepartment of Neurology, Psychology and Psychiatry Botucatu Medical School Universidade Estadual Paulista-
dc.rights.accessRightsAcesso restrito-
dc.relation.ispartofJournal of Psychiatric Research-
Appears in Collections:Artigos, TCCs, Teses e Dissertações da Unesp

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