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SELF-TRANSCENDENCE IN OBSESSIVE COMPULSIVE DISORDER: AN EXPLORATORY STUDY OF PSYCHOPATHOLOGICAL, SOCIODEMOGRAPHIC AND CLINICAL ASPECTS
Abstracts of the ICOCS 12th Scientific Meeting In conjunction with the ECNP OCRN meeting, 2016 dimensions. To facilitate the understanding of the factor analysis, the depressive-anxious factors were grouped in four general factors: emotional, cognitive, autonomic (or somatic) and behavioral aspects. Results: The factorial analysis results in five factors that describe the depressive-anxious factors present in OCD as a unique disorder (low functionality on patient’s occupation, irritability and sexual dysfunction, tremors, lack of appetite, and low selfesteem and guilty). Other fourteen depressive-anxious factors were specifically related to the six DY-BOCS dimensions, especially for sexual/religious dimension, which the cognitive factor was not related to, while for the other dimensions, cognitive aspects were always important. Conclusion: Depressive-anxious specific factors found in our study described different psychopathological aspects of OCD patients, depending on the OCS predominant content. Sexual/religious dimension seems to be different from the other DY-BOCS dimension according to the depressiveanxious factors presentation. As the specific depressiveanxious symptoms may interfere in cognitive, emotional, behavioral and autonomic aspects of OCD patients, it is quite reasonable to argue that they may contribute to the refractoriness of some cases, turning available conventional treatments obsolete or insufficient. The results of this study extend the load of evidence that OCD is a heterogeneous disorder. This heterogeneity is not only in its nuclear symptomatic presentations, but also in terms of its secondary depressive and anxious issues. It is also suggestible that each group of patients (depending on the OCS or depressiveanxious presentation) may require an individualized therapeutic approach, which targets the main features of each OCS dimension.
Financial disclosure None
Policy and ethics needed The authors declare that all experiments on human subjects and animal experiments were conducted in accordance with the relevant ethical standards and have passed the appropriate ethics boards. http://dx.doi.org/10.1016/j.euroneuro.2017.10.016
SELF-TRANSCENDENCE IN OBSESSIVE COMPULSIVE DISORDER: AN EXPLORATORY STUDY OF PSYCHOPATHOLOGICAL, SOCIODEMOGRAPHIC AND CLINICAL ASPECTS Ygor A Ferrão1, Renata Silva2, Leonardo Gonçalves2, Rafaella Porto3, Leandro Pizutti4
773
1
Porto Alegre Health Sciences Federal University, Dept of Psychiatry, Porto Alegre, Brazil 2 UFCSPA, Psychiatry, Porto Alegre, Brazil 3 UFCSPA, Health Sciences Post-graduation Program, Porto Alegre, Brazil 4 HMIPV, Psychiatry, Porto Alegre, Brazil
The obsessive-compulsive disorder (OCD) is a chronic disease that can cause serious functional and family impairment. According to Cloninger 's personality model some temperament and character factors have been associated with specific psychopathology and disease severity of OCD. However, some trait characters like self-transcendence (ST) still wasn’t properly explored in this context. Descriptions of religious content of OCD symptoms are found in sacred books from the 2nd century and are called scrupulosity. There are few studies evaluating the role of spirituality in the OCD concept, which differs from religion, since spirituality could be defined as the focus on spiritual things and the spirit world rather than on earthly and physical things, while religion is a set of beliefs and rituals that claim to put his followers in a right relationship with God. This article aims to assess whether the construct of SF in Temperament and Character Inventory (TCI) may be related to the concept of spirituality and if it could have a protective property in OCD psychopathology. This is an exploratory case-control study involving 49 patients with OCD divided into two groups: high and low ST. Variables with a Po0,2 in the univariate analysis, respecting multicollinearity and clinical-epidemiologic relevance, were included in a multiple logistic regression analysis (with forward variable selection and Wald statistics to denote significance of variables in the model) to determine if the factors were independently associated to higher ST. Results: High ST was associated to the diagnosis of major depression (Odds ratio = 7.87, p= 0.042), and to the scores of contamination and cleaning dimensions according of the DYBOCS (Dimensional Yale Brown Obsessive-Compulsive Scale) (Odds ratio = 1.56, p= 0.004). Patients with high ST also showed higher family suffering (p = 0.02) and better quality of life (QoL) (specifically on physical dimension (p = 0.05) and social concerns (p =0.03)), but those variables did not remain at the regression model. According to literature, the association of high ST and Harm Avoidance and low Self-Directness traits can constitute a schizotypy marker, and therefore may represent vulnerability to mood disorders, such as major depression. This aspect could also explain the association of high-ST with higher family suffering (also found in this study), since these patients have higher unemployment and social withdrawal and thus require greater family care. One hypothesis to explain the strong association to major depression comorbidity is that the ST is high in more severe OCD patients as those with comorbid major depression and, in this case, it could be associated with magical thinking,
774 thought-action fusion and even psychotic symptoms. That is, instead of representing transpersonal identification and spiritual acceptance transcendence could reflect loss in the definition of the self. However, longitudinal studies are necessary to further investigate the direction of cause and effect of these aspects. ST could not be considered a protective factor in OCD as it is associated with worsening of contamination/cleaning OCD symptoms and comorbid depression.
Financial disclosure None http://dx.doi.org/10.1016/j.euroneuro.2017.10.017
Financial disclosure None
Policy and ethics needed The authors declare that all experiments on human subjects and animal experiments were conducted in accordance with the relevant ethical standards and have passed the appropriate ethics boards. http://dx.doi.org/10.1016/j.euroneuro.2017.10.016
SELF-TRANSCENDENCE IN OBSESSIVE COMPULSIVE DISORDER: AN EXPLORATORY STUDY OF PSYCHOPATHOLOGICAL, SOCIODEMOGRAPHIC AND CLINICAL ASPECTS Ygor A Ferrão1, Renata Silva2, Leonardo Gonçalves2, Rafaella Porto3, Leandro Pizutti4
773
1
Porto Alegre Health Sciences Federal University, Dept of Psychiatry, Porto Alegre, Brazil 2 UFCSPA, Psychiatry, Porto Alegre, Brazil 3 UFCSPA, Health Sciences Post-graduation Program, Porto Alegre, Brazil 4 HMIPV, Psychiatry, Porto Alegre, Brazil
The obsessive-compulsive disorder (OCD) is a chronic disease that can cause serious functional and family impairment. According to Cloninger 's personality model some temperament and character factors have been associated with specific psychopathology and disease severity of OCD. However, some trait characters like self-transcendence (ST) still wasn’t properly explored in this context. Descriptions of religious content of OCD symptoms are found in sacred books from the 2nd century and are called scrupulosity. There are few studies evaluating the role of spirituality in the OCD concept, which differs from religion, since spirituality could be defined as the focus on spiritual things and the spirit world rather than on earthly and physical things, while religion is a set of beliefs and rituals that claim to put his followers in a right relationship with God. This article aims to assess whether the construct of SF in Temperament and Character Inventory (TCI) may be related to the concept of spirituality and if it could have a protective property in OCD psychopathology. This is an exploratory case-control study involving 49 patients with OCD divided into two groups: high and low ST. Variables with a Po0,2 in the univariate analysis, respecting multicollinearity and clinical-epidemiologic relevance, were included in a multiple logistic regression analysis (with forward variable selection and Wald statistics to denote significance of variables in the model) to determine if the factors were independently associated to higher ST. Results: High ST was associated to the diagnosis of major depression (Odds ratio = 7.87, p= 0.042), and to the scores of contamination and cleaning dimensions according of the DYBOCS (Dimensional Yale Brown Obsessive-Compulsive Scale) (Odds ratio = 1.56, p= 0.004). Patients with high ST also showed higher family suffering (p = 0.02) and better quality of life (QoL) (specifically on physical dimension (p = 0.05) and social concerns (p =0.03)), but those variables did not remain at the regression model. According to literature, the association of high ST and Harm Avoidance and low Self-Directness traits can constitute a schizotypy marker, and therefore may represent vulnerability to mood disorders, such as major depression. This aspect could also explain the association of high-ST with higher family suffering (also found in this study), since these patients have higher unemployment and social withdrawal and thus require greater family care. One hypothesis to explain the strong association to major depression comorbidity is that the ST is high in more severe OCD patients as those with comorbid major depression and, in this case, it could be associated with magical thinking,
774 thought-action fusion and even psychotic symptoms. That is, instead of representing transpersonal identification and spiritual acceptance transcendence could reflect loss in the definition of the self. However, longitudinal studies are necessary to further investigate the direction of cause and effect of these aspects. ST could not be considered a protective factor in OCD as it is associated with worsening of contamination/cleaning OCD symptoms and comorbid depression.
Financial disclosure None http://dx.doi.org/10.1016/j.euroneuro.2017.10.017