Gregoris Simos

Psychometric validation of the Obsessive Beliefs Questionnaire and the Interpretation of Intrusions Inventory: Part I

This article reports on the validation of the Obsessive Beliefs Questionnaire (OBQ) and Interpretations of Intrusions Inventory (III) developed by the Obsessive Compulsive Cognitions Working Group (OCCWG) to assess the primary beliefs and appraisals considered critical to the pathogenesis of obsessions. A battery of questionnaires that assessed symptoms of anxiety, depression, obsessive-compulsive symptoms and worry was administered to 248 outpatients with a DSM-IV diagnosis of Obsessive-Compulsive Disorder (OCD), 105 non-obsessional anxious patients, 87 non-clinical adults from the community, and 291 undergraduate students. Tests of internal consistency and test-retest reliability indicated that the OBQ and III assessed stable aspects of OC-related thinking. Between-group differences and correlations with existing measures of OC symptoms indicated that the OBQ and III assess core cognitive features of obsessionality. However, the various subscales of the OBQ and III are highly correlated, and both measures evidenced low discriminant validity. The findings are discussed in terms of the relevance and specificity of cognitive constructs like responsibility, control and importance of thoughts, overestimated threat, tolerance of uncertainty and perfectionism for OCD.

Assessment of dysfunctional working models of self and others in schizophrenic patients: a summary of data collected in nine nations

Objective: To investigate the cross‐cultural feasibility of a new scale for assessing dysfunctional working models of self and others, and to evaluate its discriminative power.

CBT for Anxiety Disorders: A Practitioner Book

negative findings. Inside psychiatry, academic psychiatrists are taken to task. The understandable desire for precision has led to diagnostic inflation into ever more categories (thank you, DSM). Low thresholds for disease intensity threaten to define millions more as ‘cases’. Although he addresses psychiatry as a whole, his outlook is inevitably framed by current issues in North American psychiatry. Many of us in the UK National Health Service seldom see anyone without a psychosis, so diagnostic inflation may seem somewhat academic. Some North American notions such as ‘hospital privileges’ need explanation. And, in the UK at least, quetiapine is not, as yet, ‘the new Valium’. I blame the editors. Who is this book for? It is too sober and scholarly for a general readership, which will expect tales of fiendish experiments and outlandish treatments. The voice is often that of a valedictory address, which may be too personal for the more academic. This book could most benefit the new entrant to psychiatry, pulled this way and that by fashion, optimism and authority. It could help to balance their necessary (and healthy) therapeutic optimism with a corrective evidence-based scepticism. And embolden the tyro to challenge the teacher, however authoritative, charming or charismatic that teacher might be.

Medication Effects on Obsessions and Compulsions

Publisher Summary This chapter examines the medication effects on obsessions and compulsions. The differential response of obsessive compulsive disorder (OCD) and depression to clomipramine and to other antidepressants provides an insight to the underlying psychological mechanism. The efficacy of clomipramine and the failure of other classes of antidepressants in OCD have made researchers speculate that the principal anti-obsessive action of clomipramine is through its potent inhibitory effect on serotonin reuptake. Therefore, alterations in serotonin function are considered critical to the treatment of OCD and perhaps involved in its pathogenesis. The efficacy of clomipramine in OCD and the resulting serotonin hypothesis led to the research with a newer category of antidepressant drugs, the selective serotonin re-uptake inhibitors (SSRI). These newer drugs, including fluvoxamine, fluoxetine, sertraline, paroxetine and citalopram, have a more selective and potent action on serotonin neurotransmission and cause minimal inhibition of other neurotransmitter re-uptake. Although SSRIs are the mainstream of pharmacologic treatment for OCD, SSRI refractory patients seem to benefit by adding other classes of medication to the SSRI. A number of studies have examined the effect of adding various medications. In particular, risperidone, a novel antipsychotic, was found to be effective in augmenting SSRI treatment of OCD.

Cognitive-Behavioural Treatment of Culturally Bound Obsessional Ruminations: A Case Report

Therapeutic management of obsessional ideas without compulsions is considered to be a rather difficult clinical problem. This report discusses the case of a 24-year old lady with a nine year history of recurrent Obsessive-Compulsive Disorder which most recently presented with a year-long obsessional rumination concerning her superstitious personal responsibility for the accidental death of her cousin. Repeated audio-taped listening to the cognitively restructured content of her obsession resulted both in a rapid elimination of her ruminations and the alleviation of her depressive and general psychopathology.

Epidemiology and comorbidity of obsessive–compulsive disorder in late adolescence: a cross-sectional study in senior high schools in Greece

Abstract Objective: The aim of this study was to examine the epidemiology, comorbidity and use of health services of obsessive–compulsive disorder (OCD) and subclinical obsessive–compulsive symptoms in late adolescence. Methods: A total of 2427 adolescents attending senior high schools in Greece were selected for a detailed psychiatric interview using the revised clinical interview schedule (CIS-R). Use of alcohol, nicotine and cannabis, and several socio-demographic and socio-economic variables were also assessed. Results: The prevalence of OCD was 1.39% (95% confidence interval [CI]: 1.05–1.84) while that of subclinical obsessive–compulsive symptoms was 2.77% (2.22–3.45). There was a female preponderance for subclinical symptoms. Financial difficulties of the family was the only socio-demographic variable that was significantly associated with OCD but not with subclinical symptoms. The pattern of comorbidity was similar for both conditions but milder in the subclinical form. About one in three reported use of general health services and one in ten use of psychiatric services. Conclusions: OCD and subclinical obsessive–compulsive symptoms were relatively common. Comorbidity with other psychiatric disorders and use of substances was considerable even in subclinical status, but use of specialised health services was small. Clinical and research implications are discussed.