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Fulltext Urinary frequency: going beyond the tract

Rahmat R

Malays Fam Physician, 2020;15(1):58-60.
PMID: 32284808

Obsessive-compulsive disorder (OCD) is a common anxiety disorder which can be chronic and sustained. An OCD sufferer experiences intrusive and repetitive thoughts, impulses, and behaviors, which ultimately cause extreme discomfort. We report a case of a patient that primarily presented with lower urinary tract symptoms who was subsequently treated with antibiotics. Nonetheless, the symptoms persisted. In subsequent consultations, the patient clarified the compulsive nature of his symptoms and was treated as a case of OCD. Therefore, it is crucial for physicians to correctly identify the nature of the symptoms to manage the disorder properly and to avoid unnecessary consultation and treatment. To the best of our knowledge, this is the first report of other presentations of OCD.

Matched MeSH terms: Obsessive-Compulsive Disorder*
Fulltext Treatment of an obsessive compulsive disorder by desensitisation

Etheridge AF

Med J Malaysia, 1983 Jun;38(2):137-41.
PMID: 6137757

The present study reports on a successful treatment of a single case of obsessive compulsive neurosis using a behavioural technique, namely, systematic desensitisation. Much recent literature has suggested that behavioural techniques may be more helpful with this particularly difficult condition than traditional methods of treatment, such as medication. The present results suggest that the technique of systematic desensitisation may be successfully used in a non-western setting.

Matched MeSH terms: Obsessive-Compulsive Disorder/therapy*
Fulltext Auditory hallucination in an obsessive compulsive disorder adolescent

Khadijah, H.A.A., Seed, H.F., Lee, V.Y., Wan Salwina, W.I.

Malaysian Journal of Psychiatry, 2014;23(2):86-89.
MyJurnal

Although comorbidity of obsessive compulsive disorder (OCD) with schizophrenia is well-established, the occurrence of psychotic symptoms especially hallucinations with OCD still requires further studies. We report a case of a child with OCD who experienced auditory hallucination with the recurrence of his OCD symptoms and the management involved. We discussed the possible differentials when auditory hallucinations occur in the context of OCD.

Matched MeSH terms: Obsessive-Compulsive Disorder
Fulltext Obsessive compulsive schizophrenia (OCS) revisited: a five-year case report

Marhani Midin, Reddy, Jaya Prakash, Nik Ruzyanei Nik Jaafar

ASEAN Journal of Psychiatry, 2009;10(1):95-98.
MyJurnal

Objective: This is a case report discussing the comorbidity of obsessive compulsive disorder (OCD) and schizophrenia. Such clinical phenomenon merits recognition as a distinct subgroup of schizophrenia with unique challenges and treatment needs. Method: A case report presenting schizophrenia with preceding obsessive-compulsive disorder over five years. Results: This report describes the clinical course and treatment challenges of a patient with obsessive compulsive schizophrenia (OCS). Conclusion: This case illustrates that OCS is a complex disorder with atypical clinical characteristics. In managing this patient, several clinical dilemmas including diagnostic ambiguity, problems with pharmacotherapy and difficulties in his rehabilitation were highlighted.

Matched MeSH terms: Obsessive-Compulsive Disorder
Fulltext Dilemma of diagnosing OCD: a case report

Ridzwan, H., Saifuddin, T.M.

Malaysian Journal of Psychiatry, 2017;26(2):0-0.
MyJurnal

Obsessive Compulsive Disorder (OCD) may present in the prodromal phase
of schizophrenia. However at times it is difficult to distinguish between the
pure obsession and psychotic obsessions that exist in patients. We present a
case of a patient initially diagnosed as Schizophrenia due to the disorganized
aspect of her behaviour, only to discover an extreme form of obsessions that
explained her demeanor throughout.

Matched MeSH terms: Obsessive-Compulsive Disorder
Unremitting body odour: A case of Olfactory Reference Syndrome

Tee CK, Suzaily W

Clin Ter, 2015;166(2):72-3.
PMID: 25945434 DOI: 10.7417/CT.2015.1819

Olfactory reference syndrome (ORS) is a person's fear of exuding an offensive body odour which is not perceived by others. The objective of this case report is to highlight the challenges in diagnosing olfactory reference syndrome due to the lack of diagnostic criteria as well as its similarities to other psychiatric illnesses. We report a case of a young Chinese gentleman who was preoccupied with the belief that he had an offensive body odour which was not noticeable by others since the age of 10. As a result of this, he developed compulsive behaviour, social anxiety and avoidance, as well as depression. The patient had an array of psychiatric symptoms. He had symptoms which fulfilled criteria for obsessive compulsive disorder (OCD), delusional disorder somatic type, and social anxiety disorder. ORS remains a diagnostic challenge. Further studies are needed in this area for a better understanding of the disorder.

Matched MeSH terms: Obsessive-Compulsive Disorder/psychology
The treatment of an obsessive-compulsive girl in the context of Malaysian Chinese culture

Ong SB, Leng YK

Aust N Z J Psychiatry, 1979 Sep;13(3):255-9.
PMID: 293181

The case history, treatment and follow-up of a thirteen-year-old girl with obsessive-compulsive neurosis of six months duration are reported. Results show that behaviour modification techniques were effective though a second course of treatment was required. Her illness and its treatment by behaviour therapy in relation to the Malaysian Chinese culture is discussed.

Matched MeSH terms: Obsessive-Compulsive Disorder/therapy*
An Integrative Approach to Treatment-Resistant Obsessive-Compulsive Disorder

Woon LS, Kanapathy A, Zakaria H, Alfonso CA

Psychodyn Psychiatry, 2017;45(2):237-257.
PMID: 28590207 DOI: 10.1521/pdps.2017.45.2.237

Obsessive-compulsive disorder (OCD) is a debilitating psychiatric disorder that often runs a chronic unremitting course. Treatment outcomes can be unsatisfactory despite the availability of various somatic and psychological therapies. Psychodynamic psychotherapy in combination with cognitive behavioral therapy (CBT) with exposure and response prevention (ERP) could help patients with treatment-resistant OCD achieve better outcomes. An integrative approach can help patients gain insight, strengthen the therapeutic alliance, improve treatment adherence, and provide symptomatic relief when other treatments seem insufficient or have failed. We describe the treatment process of a person with treatment-resistant OCD who received pharmacotherapy, concurrent CBT/ERP, and a brief course of psychodynamic psychotherapy. Case formulations from cognitive behavioral and psychodynamic perspectives are presented. The authors discuss the advantages of doing a psychodynamic assessment and formulation in treatment refractory cases and the wisdom of integrating psychotherapy interventions for OCD, as well as the unique clinical features of cases that warrant a multimodal treatment approach.

Matched MeSH terms: Obsessive-Compulsive Disorder/therapy*
Cortical glutamate and GABA are related to compulsive behaviour in individuals with obsessive compulsive disorder and healthy controls

Biria M, Banca P, Healy MP, Keser E, Sawiak SJ, Rodgers CT, et al.

Nat Commun, 2023 Jun 27;14(1):3324.
PMID: 37369695 DOI: 10.1038/s41467-023-38695-z

There has been little analysis of neurochemical correlates of compulsive behaviour to illuminate its underlying neural mechanisms. We use 7-Tesla proton magnetic resonance spectroscopy (1H-MRS) to assess the balance of excitatory and inhibitory neurotransmission by measuring glutamate and GABA levels in anterior cingulate cortex (ACC) and supplementary motor area (SMA) of healthy volunteers and participants with Obsessive-Compulsive Disorder (OCD). Within the SMA, trait and clinical measures of compulsive behaviour are related to glutamate levels, whereas a behavioural index of habitual control correlates with the glutamate:GABA ratio. Participants with OCD also show the latter relationship in the ACC while exhibiting elevated glutamate and lower GABA levels in that region. This study highlights SMA mechanisms of habitual control relevant to compulsive behaviour, common to the healthy sub-clinical and OCD populations. The results also demonstrate additional involvement of anterior cingulate in the balance between goal-directed and habitual responding in OCD.

Matched MeSH terms: Obsessive-Compulsive Disorder*
Fulltext Understanding trypophobia: the fear of holes

Aminuddin, I., Lotfi, H.A.

Malaysian Journal of Psychiatry, 2016;25(2):0-0.
MyJurnal

The sight of clustered holes can bring about uneasiness in people, and the disgust response towards it is called trypophobia. Reactions in humans vary from nausea to severe depression. We explore the possible causes of this unique phenomenon, such as evolutionary adaptation and spectral features. We also uncover the clinical features and its relationship to other psychological conditions for example, obsessive-compulsive disorder.

Matched MeSH terms: Obsessive-Compulsive Disorder
Fulltext Association of Environmental Uncertainty With Altered Decision-making and Learning Mechanisms in Youths With Obsessive-Compulsive Disorder

Marzuki AA, Tomic I, Ip SHY, Gottwald J, Kanen JW, Kaser M, et al.

JAMA Netw Open, 2021 Nov 01;4(11):e2136195.
PMID: 34842925 DOI: 10.1001/jamanetworkopen.2021.36195

IMPORTANCE: Adults with obsessive-compulsive disorder (OCD) display perseverative behavior in stable environments but exhibit vacillating choice when payoffs are uncertain. These findings may be associated with intolerance of uncertainty and compulsive behaviors; however, little is known about the mechanisms underlying learning and decision-making in youths with OCD because research into this population has been limited.
OBJECTIVE: To investigate cognitive mechanisms associated with decision-making in youths with OCD by using executive functioning tasks and computational modeling.
DESIGN, SETTING, AND PARTICIPANTS: In this cross-sectional study, 50 youths with OCD (patients) and 53 healthy participants (controls) completed a probabilistic reversal learning (PRL) task between January 2014 and March 2020. A separate sample of 27 patients and 46 controls completed the Wisconsin Card Sorting Task (WCST) between January 2018 and November 2020. The study took place at the University of Cambridge in the UK.
MAIN OUTCOMES AND MEASURES: Decision-making mechanisms were studied by fitting hierarchical bayesian reinforcement learning models to the 2 data sets and comparing model parameters between participant groups. Model parameters included reward and punishment learning rates (feedback sensitivity), reinforcement sensitivity and decision consistency (exploitation), and stickiness (perseveration). Associations of receipt of serotonergic medication with performance were assessed.
RESULTS: In total, 50 patients (29 female patients [58%]; median age, 16.6 years [IQR, 15.3-18.0 years]) and 53 controls (30 female participants [57%]; median age, 16.4 years [IQR, 14.8-18.0 years]) completed the PRL task. A total of 27 patients (18 female patients [67%]; median age, 16.1 years [IQR, 15.2-17.2 years]) and 46 controls (28 female participants [61%]; median age, 17.2 [IQR, 16.3-17.6 years]) completed the WCST. During the reversal phase of the PRL task, patients made fewer correct responses (mean [SD] proportion: 0.83 [0.16] for controls and 0.61 [0.31] for patients; 95% CI, -1.31 to -0.64) and switched choices more often following false-negative feedback (mean [SD] proportion: 0.09 [0.16] for controls vs 0.27 [0.34] for patients; 95% CI, 0.60-1.26) and true-positive feedback (mean [SD] proportion: 0.93 [0.17] for controls vs 0.73 [0.34] for patients; 95% CI, -2.17 to -1.31). Computational modeling revealed that patients displayed enhanced reward learning rates (mean difference [MD], 0.21; 95% highest density interval [HDI], 0.04-0.38) but decreased punishment learning rates (MD, -0.29; 95% HDI, -0.39 to -0.18), reinforcement sensitivity (MD, -4.91; 95% HDI, -9.38 to -1.12), and stickiness (MD, -0.35; 95% HDI, -0.57 to -0.11) compared with controls. There were no group differences on standard WCST measures and computational model parameters. However, patients who received serotonergic medication showed slower response times (mean [SD], 1420.49 [279.71] milliseconds for controls, 1471.42 [212.81] milliseconds for patients who were unmedicated, and 1738.25 [349.23] milliseconds for patients who were medicated) (control vs medicated MD, -320.26 [95% CI, -547.00 to -88.68]) and increased unique errors (mean [SD] proportion: 0.001 [0.004] for controls, 0.002 [0.004] for patients who were unmedicated, and 0.008 [0.01] for patients who were medicated) (control vs medicated MD, -0.007 [95% CI, -3.14 to -0.36]) on the WCST.
CONCLUSIONS AND RELEVANCE: The results of this cross-sectional study indicated that youths with OCD showed atypical probabilistic reversal learning but were generally unimpaired on the deterministic WCST, although unexpected results were observed for patients receiving serotonergic medication. These findings have implications for reframing the understanding of early-onset OCD as a disorder in which decision-making is associated with uncertainty in the environment, a potential target for therapeutic treatment. These results provide continuity with findings in adults with OCD.

Matched MeSH terms: Obsessive-Compulsive Disorder/physiopathology*; Obsessive-Compulsive Disorder/psychology*
Blood-based dynamic genomic signature for obsessive-compulsive disorder

Wang Y, Cheng C, Zhang Z, Wang J, Wang Y, Li X, et al.

Am J Med Genet B Neuropsychiatr Genet, 2018 12;177(8):709-716.
PMID: 30350918 DOI: 10.1002/ajmg.b.32675

No biologically based diagnostic criteria are in clinical use today for obsessive-compulsive disorder (OCD), schizophrenia, and major depressive disorder (MDD), which are defined with reference to Diagnostic and Statistical Manual clinical symptoms alone. However, these disorders cannot always be well distinguished on clinical grounds and may also be comorbid. A biological blood-based dynamic genomic signature that can differentiate among OCD, MDD, and schizophrenia would therefore be of great utility. This study enrolled 77 patients with OCD, 67 controls with no psychiatric illness, 39 patients with MDD, and 40 with schizophrenia. An OCD-specific gene signature was identified using blood gene expression analysis to construct a predictive model of OCD that can differentiate this disorder from healthy controls, MDD, and schizophrenia using a logistic regression algorithm. To verify that the genes selected were not derived as a result of chance, the algorithm was tested twice. First, the algorithm was used to predict the cohort with true disease/control status and second, the algorithm predicted the cohort with disease/control status randomly reassigned (null set). A six-gene panel (COPS7A, FKBP1A, FIBP, TP73-AS1, SDF4, and GOLGA8A) discriminated patients with OCD from healthy controls, MDD, and schizophrenia in the training set (with an area under the receiver-operating-characteristic curve of 0.938; accuracy, 86%; sensitivity, 88%; and specificity, 85%). Our findings indicate that a blood transcriptomic signature can distinguish OCD from healthy controls, MDD, and schizophrenia. This finding further confirms the feasibility of using dynamic blood-based genomic signatures in psychiatric disorders and may provide a useful tool for clinical staff engaged in OCD diagnosis and decision making.

Matched MeSH terms: Obsessive-Compulsive Disorder/blood*; Obsessive-Compulsive Disorder/diagnosis; Obsessive-Compulsive Disorder/genetics*
The relation of childhood trauma to suicide ideation in patients suffering from obsessive-compulsive disorder with lifetime suicide attempts

Khosravani V, Kamali Z, Jamaati Ardakani R, Samimi Ardestani M

Psychiatry Res, 2017 09;255:139-145.
PMID: 28549337 DOI: 10.1016/j.psychres.2017.05.032

The aim of this study was to evaluate the relations of childhood trauma (CT) and obsessive-compulsive (OC) symptom dimensions to suicide ideation in patients with obsessive-compulsive disorder (OCD). Seventy OCD outpatients with lifetime suicide attempts and 60 controls were included. Participants completed the Scale for Suicide Ideation (SSI), the Childhood Trauma Questionnaire-Short Form (CTQ-SF), the Yale-Brown Obsessive Compulsive Scale (Y-BOCS), the Dimensional Obsessive-Compulsive Scale (DOCS) and the Depression Anxiety Stress Scales (DASS-21). Among OCD patients, 97.1% had current suicide ideation. OCD patients revealed higher scores on CT, suicide ideation, depression and anxiety than controls. The CT history of sexual abuse (SA) and OC symptom dimension of unacceptable thoughts explained suicide ideation. It was concluded that SA and unacceptable thoughts may contribute to high suicidality and have important implications for the assessment and treatment of suicide risk in OCD patients with lifetime suicide attempts.

Matched MeSH terms: Obsessive-Compulsive Disorder/diagnosis; Obsessive-Compulsive Disorder/epidemiology; Obsessive-Compulsive Disorder/psychology*
Fulltext Atypical antipsychotic induced obsessive-compulsive symptoms

Teh EE, Najib MAM

Med J Malaysia, 2004 Dec;59(5):690-1.
PMID: 15889578
Matched MeSH terms: Obsessive-Compulsive Disorder/chemically induced*
Postpartum obsessive-compulsive symptoms in a case of peripartum-onset depression and infanticide

Lee KKS, Yahya B

Asian J Psychiatr, 2019 Jan;39:10-11.
PMID: 30466055 DOI: 10.1016/j.ajp.2018.11.004
Matched MeSH terms: Obsessive-Compulsive Disorder/diagnosis*
Fulltext Preliminary Analysis of the Factor Structure, Reliability and Validity of an Obsessive-Compulsive Disorder Screening Tool for Use with Adults in Malaysia

Che Din N, Mohd Nawi L, Ghazali SE, Ahmad M, Ibrahim N, Said Z, et al.

Int J Environ Res Public Health, 2019 Nov 28;16(23).
PMID: 31795076 DOI: 10.3390/ijerph16234763

This is a preliminary study to examine the factor structure, reliability, and validity of an obsessive-compulsive disorder (OCD) screening tool for use in the Malaysian setting. A total of 199 Malaysian adults were recruited for this study. After cleaning and normalizing the data, 190 samples were left to be analyzed. Principle component analysis using varimax rotation was then performed to examine various factors derived from psychometric tools commonly used to assess OCD patients. The screening tool exhibited three factors that fit the description of obsessions and compulsions from the Diagnostic and Statistical Manual of Mental Disorders-5th Edition (DSM 5), as well as other common symptoms that co-morbid with OCD. The labels given to the three factors were: Severity of Compulsions, Severity of Obsessions, and Symptoms of Depression and Anxiety. Reliability analysis showed high reliability with a Cronbach's alpha of 0.94, whereas convergent validity of the tool with the Yale Brown Obsessive-compulsive Scale-Self Report demonstrated good validity of r = 0.829. The three-factor model explained 68.91% of the total variance. Subsequent studies should focus on OCD factors that are culturally unique in the Malaysian context. Future research may also use online technology, which is cost-efficient and accessible, to further enhance the screening tool.

Matched MeSH terms: Obsessive-Compulsive Disorder/diagnosis*
Fulltext Observe your child ablution; they could have obsessive-compulsive disorders

Norzila Zakaria, Ahmad ShahrilAb. Halim, Ramiza Ramza Ramli, Raishan Shafini Bakar, Agustine Nengsih Fauzi, Nur-Fazimah Sahran, et al.

Malaysian Journal of Paediatrics and Child Health, 2019;25(2):30-32.
MyJurnal

Obsessive-compulsive disorder (OCD) is a neuropsychiatric disorder characterized by recurrent intrusive, distressing thoughts and repetitive behaviours or mental rituals performed to reduce anxiety. The lifetime prevalence of OCD is 2.3% and it can happen to all people of various levels, including child and adolescent. The mean age of onset is 19.5 years, and a subset of patients, mostly males, have an early onset before 10 years of age. The lifetime risk of developing OCD is higher in females, who typically develop the disorder in adolescence [1]. Person with OCD usually presented with obsession involving various themes, namely contamination; repeated doubts; religious, need for symmetry and exactness, or taboo thoughts of a sexual, religious, or aggressive nature. Whereas, the most common compulsions are checking, washing, hoarding, and counting compulsions[1]. (Copied from article).

Matched MeSH terms: Obsessive-Compulsive Disorder
Fulltext Voyeurism with sexual fantasy on female body parts: a subtype of obsessive-compulsive disorder?

Sidi H, Midin M

Malaysian Journal of Psychiatry, 2008;17(1):94-99.

The compulsive behaviour of observing an unsuspecting person undressing or being naked in voyeurism may be related to Obsessive-Compulsive spectrum disorder. The aim of this paper is to report a case that reiterates a unique psychopathology of a Malaysian male voyeur with an obsession on female body parts. This 35 year-old voyeur man who attended psychiatric outpatient clinic in an academic medical centre presented to a psychiatrist for taking photos of his sisters' naked bodies and collected nails and hairs from their body, coded them with intend for masturbation. His voyeuristic thoughts and urges which came repeatedly and intrusively, involving attempts to resist them and was associated with an inner tension for the urges to be fulfilled. He responded both to Paroxetine and behaviour therapy. The possibility that voyeurism, a paraphilia can manifest itself as a subtype of OCD is discussed. Keywords: Malaysian voyeur, obsession-compulsive spectrum disorder, body parts

Matched MeSH terms: Obsessive-Compulsive Disorder
Fulltext Obsessive-Compulsive Disorder in Schizophrenia: Clinical and Neurocognitive Correlates

Abdul Hamid, A.R., Abdul Razak, O.

Malaysian Journal of Psychiatry, 2010;19(2):1-9.
MyJurnal

This study aims to determine the prevalence of obsessive compulsive disorder (OCD) among schizophrenic patients and the association of this condition with clinical and selected neurocognitive factors. This is a cross sectional study on one hundred schizophrenic patients who attended psychiatric clinic in National University Hospital and Kuala Lumpur Hospital over a four-months period. All patients diagnosed as schizophrenia according to DSM 1V were assessed using Mini International Neuropsychiatric Interview (MINI) Version 5 for the presence of Obsessive Compulsive Disorder, Brief Psychiatric rating Scale (BPRS) for severity of psychosis and Yale Brown Obsessive Compulsive Scale (YBOCS) for severity of obsessive compulsive (OC) symptoms. Socio-demographic data were obtained by direct interview. The neurocognitive assessment were done using Mini Mental State Examination , Rey Auditory Verbal Learning Test (RAVLT) and Digit Span. Fifteen percent of schizophrenic patients (15%) in this sample were found to have a diagnosis of Obsessive compulsive Disorder (OCD). The OCD and non-OCD schizophrenic patients did not differ significantly in term of age ,gender, race and family history of mental illness. However they differ significantly on employment, type of treatment medication and the presence or severity of current psychosis. Schizophrenic patients with OCD also showed no significant different in selected neurocognitive functions.

Matched MeSH terms: Obsessive-Compulsive Disorder
Fulltext A case of a living doll: a case report on Anorexia Nervosa with co-morbid obsessive-compulsive disorder by proxy

Koh, B.Y.E., Norharlina, B.

Malaysian Journal of Psychiatry, 2015;24(2):0-0.
MyJurnal

The authors report a case of co-morbid diagnosis Anorexia Nervosa (AN) with co-morbid diagnosis of Obsessive-compulsive Disorder (OCD) by proxy. The patient is a 16-year-old female who presented to the emergency department with features of AN and also OCD. To reduce the anxiety of her AN, she incorporated her mother as a proxy to follow specific instructions. The patient received both inpatient and outpatient support, and her condition gradually improved with antidepressants and antipsychotics. This case illustrates a co-morbid presentation of OCD with AN and also the result of family accommodation that led to the family member aiding with the compulsion. Treatment for the case was also briefly discussed.
Study site: emergency department (unspecified)

Matched MeSH terms: Obsessive-Compulsive Disorder

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