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Obsessive-compulsive disorder is associated with broad impairments in executive function: A meta-analysis.

ABSTRACT: Obsessive-compulsive disorder (OCD) is a serious and often chronically disabling condition. The current dominant model of OCD focuses on abnormalities in prefrontal-striatal circuits that support executive function (EF). While there is growing evidence for EF impairments associated with OCD, results have been inconsistent, making the nature and magnitude of these impairments controversial. The current meta-analysis uses random-effects models to synthesize 110 previous studies that compared participants with OCD to healthy control participants on at least one neuropsychological measure of EF. The results indicate that individuals with OCD are impaired on tasks measuring most aspects of EF, consistent with broad impairment in EF. EF deficits were not explained by general motor slowness or depression. Effect sizes were largely stable across variation in demographic and clinical characteristics of samples, although medication use, age, and gender moderated some effects.

SUBMITTER: Snyder HR

PROVIDER: S-EPMC4351670 | biostudies-literature | 2015 Mar

REPOSITORIES: biostudies-literature

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Obsessive-compulsive disorder is associated with broad impairments in executive function: A meta-analysis.

Snyder Hannah R HR Kaiser Roselinde H RH Warren Stacie L SL Heller Wendy W

Clinical psychological science : a journal of the Association for Psychological Science 20150301 2

Obsessive-compulsive disorder (OCD) is a serious and often chronically disabling condition. The current dominant model of OCD focuses on abnormalities in prefrontal-striatal circuits that support executive function (EF). While there is growing evidence for EF impairments associated with OCD, results have been inconsistent, making the nature and magnitude of these impairments controversial. The current meta-analysis uses random-effects models to synthesize 110 previous studies that compared parti ...[more]

PMID: 25755918

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Project description:Introduction: Studies have shown that patients with obsessive compulsive disorder (OCD) often perform more poorly than healthy control (HC) participants on cognitive tasks involving executive functions. Most studies, however, have been performed in Western countries and societies, making it uncertain whether impaired executive functions can also be observed among non-Western patients with OCD. To address this gap in the literature, we evaluated several executive functions in Chinese patients with OCD and HCs. Methods: Participants included consisted of 46 Chinese patients with OCD (25 men, 21 women), ranging in age from 19 to 56 years, and 45 matched HCs without any self-reported lifetime psychiatric disorder. They all lived in Shanghai or the surrounding area. Five tests of the Cambridge Neuropsychological Test Automated Battery (CANTAB) were used to evaluate several executive functions (response inhibition, spatial working memory, planning, and cognitive flexibility) along with testing basic learning and visual recognition memory. Statistical tests using a Bonferroni-corrected significance level of p = 0.003 were performed to assess overall patient-control group differences in cognitive performance. Additionally, we explored performance differences between patients classified as having either relatively mild symptoms or severe symptoms based on the individual total scores on the Yale-Brown Obsessive-Compulsive Scale. Results: There were no significant performance differences between patients with OCD and HC in any of the cognitive tests. Similarly, cognitive performance of patients with relatively mild OCD symptoms did not differ significantly from that of patients with severe symptoms. Conclusions: These results do not seem to support the view that impaired executive functioning represents a basic cognitive and pathophysiological feature of Chinese patients with OCD. However, due to study limitations, additional research is required before this conclusion can be well accepted.

Project description:We investigated whether obsessive-compulsive (OC) symptoms from a population-based sample could be analyzed to detect genetic variants influencing obsessive-compulsive disorder (OCD). We performed a genome-wide association studies (GWAS) on the obsession (rumination and impulsions) and compulsion (checking, washing, and ordering/precision) subscales of an abbreviated version of the Padua Inventory (N = 8,267 with genome-wide genotyping and phenotyping). The compulsion subscale showed a substantial and significant positive genetic correlation with an OCD case-control GWAS (r G = 0.61, p = .017) previously published by the Psychiatric Genomics Consortium (PGC-OCD). The obsession subscale and the total Padua score showed no significant genetic correlations (r G = -0.02 and r G = 0.42, respectively). A meta-analysis of the compulsive symptoms GWAS with the PGC-OCD revealed no genome-wide significant Single-Nucleotide Polymorphisms (SNPs combined N = 17,992, indicating that the power is still low for individual SNP effects). A gene-based association analysis, however, yielded two novel genes (WDR7 and ADCK1). The top 250 genes in the gene-based test also showed a significant increase in enrichment for psychiatric and brain-expressed genes. S-Predixcan testing showed that for genes expressed in hippocampus, amygdala, and caudate nucleus significance increased in the meta-analysis with compulsive symptoms compared to the original PGC-OCD GWAS. Thus, the inclusion of dimensional symptom data in genome-wide association on clinical case-control GWAS of OCD may be useful to find genes for OCD if the data are based on quantitative indices of compulsive behavior. SNP-level power increases were limited, but aggregate, gene-level analyses showed increased enrichment for brain-expressed genes related to psychiatric disorders, and increased association with gene expression in brain tissues with known emotional, reward processing, memory, and fear-formation functions.

Dataset Information

Obsessive-compulsive disorder is associated with broad impairments in executive function: A meta-analysis.

Publications

Obsessive-compulsive disorder is associated with broad impairments in executive function: A meta-analysis.

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