Transcranial direct current stimulation as early augmentation in adolescent obsessive compulsive disorder:A pilot proof-of-concept randomized control trial

BACKGROUND Transcranial direct current stimulation(tDCS)is proven to be safe in treating various neurological conditions in children and adolescents.It is also an effective method in the treatment of OCD in adults.AIM To assess the safety and efficacy of tDCS as an add-on therapy in drug-naive adolescents with OCD.METHODS We studied drug-naïve adolescents with OCD,using a Children’s Yale-Brown obsessive-compulsive scale(CY-BOCS)scale to assess their condition.Both active and sham groups were given fluoxetine,and we applied cathode and anode over the supplementary motor area and deltoid for 20 min in 10 sessions.Reassessment occurred at 2,6,and 12 wk using CY-BOCS.RESULTS Eighteen adolescents completed the study(10-active,8-sham group).CY-BOCS scores from baseline to 12 wk reduced significantly in both groups but change at baseline to 2 wk was significant in the active group only.The mean change at 2 wk was more in the active group(11.8±7.77 vs 5.25±2.22,P=0.056).Adverse effects between the groups were comparable.CONCLUSION tDCS is safe and well tolerated for the treatment of OCD in adolescents.However,there is a need for further studies with a larger sample population to confirm the effectiveness of tDCS as early augmentation in OCD in this population.

Characterization of event-related potentials in obsessive compulsive disorder patients: Comparison with depression and generalized anxiety disorder patients

BACKGROUND： Study results of event-refated potential in obsessive compulsive disorder （OCD） remain controversial, potentially as a result of different instruments utilized and their differing technical characteristics. OBJECTIVE： To investigate the differences in several common event-related potentials, Le. contingent negative variations, P300, and mismatch negativity （MMN）, in OCD patients, depression patients, generalized anxiety disorder （GAD） patients, and healthy controls. DESIGN, TIME AND SETTING： A case-control study was performed in the Department of Electrophysiology, Shanghai Mental Health Center from May 2002 to December 2005. PARTICIPANTS： A total of 38 OCD patients, 20 depression patients, and 18 GAD patients, who were diagnosed according to the criteria of Chinese Classification of Mental Disorders （Version 3）, formulated by the Chinese Psychiatry Association, were selected from the Outpatient Department of Shanghai Mental Health Center. Patients with two or more the above diseases were excluded. In addition, 28 healthy people, gender and age matched, were selected as controls. METHODS： Contingent negative variations, P300, and MMN were recorded by a Nicolet Spirit Instrument. All electrodes were attached at Cz according to the Intemationa11020 system, with the mastoid leads as reference and Fpz as ground. MAIN OUTCOME MEASURES： Amplitude and latency of contingent negative variations, P300, and MMN. RESULTS： The contingent negative variations, P300, and MMN were different （P 〈 0.01）. OCD patients showed an increased MI amplitude compared with controls, depression, and GAD patients （P 〈 0.01）. Target P300 amplitudes were significantly lower in OCD, depression, and GAD patients compared with controls （P 〈 0.01）. Moreover, N2 latency and latency of MMN were prolonged in OCD and depression groups compared with controls （P 〈 0.05）. CONCLUSION： Event-related potentials were different in depression, GAD, and OCD patients and healthy controls. In particular, OCD patients exhibited unique characteristics.

Cognitive-behavioural therapy for obsessive-compulsive disorder co-occurring with psychosis: Systematic review of evidence

AIM To review available evidence on the use of cognitive behavioural therapy(CBT) for treating obsessive compulsive disorder co-occurring with psychosis.METHODS In this paper we present a detailed and comprehensive review of the current literature focusing on CBT treatment of obsessive compulsive disorder(OCD) co-occurring with schizophrenia or schizoaffective disorder. We identified relevant literature published between 2001 and May 2016 through MEDLINE/PubM ed search using as search string("obsessive compulsive disorders" or "obsessive compulsive symptoms") and("schizophrenia" or "schizoaffective disorder" or "psychosis") and("cognitive behavioural therapy"). Other citations of interest were further identified from references reported in the accessed articles. The search was limited to studies written in English and carried out in adult patients. A total of 9 studies, 8 case reports and 1 case series, were found.RESULTS The reviewed evidence indicates that CBT is:(1) safe, i.e., does not worsen psychotic symptoms;(2) well accepted, with a discontinuation rate quite similar to that reported for patients with OCD without psychosis comorbidity;(3) effective, with a symptom reduction quite similar to that reported for patients with OCD without psychosis and for SRIs treatment of OCD cooccurring with psychosis; and(4) effective in patients with OCD induced by second-generation antipsychotic as well as in patients with OCD not induced by secondgeneration antipsychotic. Alcohol/substance use disorder comorbidity and OCD onset preceding that of SCH/SA was predictors of poor outcome. These results are derived only by additional studies with adequate sample size.CONCLUSION Our results support the use of CBT for OCD in patients with psychosis.

Differential diagnosis of obsessive-compulsive symptoms from delusions in schizophrenia: A phenomenological approach

Several studies suggest increased prevalence-rates of obsessive-compulsive symptoms(OCS) and even of obsessive-compulsive disorder(OCD) in patients with schizophrenic disorders. Moreover, it has been recently proposed the existence of a distinct diagnostic subgroup of schizo-obsessive disorder. However, the further investigation of the OCS or OCD-schizophrenia diagnostic comorbidity presupposes the accurate clinical differential diagnosis of obsessions and compulsions from delusions and repetitive delusional behaviours, respectively. In turn, this could be facilitated by a careful comparative examination of the phenomenological features of typical obsessions/compulsions and delusions/repetitive delusional behaviours, respectively. Thiswas precisely the primary aim of the present investigation. Our examination included seven features of obsessions/delusions(source of origin and sense of ownership of the thought, conviction, consistency with one's belief-system, awareness of its inaccuracy, awareness of its symptomatic nature, resistance, and emotional impact) and five features of repetitive behaviours(aim of repetitive behaviours, awareness of their inappropriateness, awareness of their symptomatic nature, and their immediate effect on underlying thought, and their emotional impact). Several of these clinical features, if properly and empathically investigated, can help discriminate obsessions and compulsive rituals from delusions and delusional repetitive behaviours, respectively, in patients with schizophrenic disorders. We comment on the results of our examination as well as on those of another recent similar investigation. Moreover, we also address several still controversial issues, such as the nature of insight, the diagnostic status of poor insight in OCD, the conceptualization and differential diagnosis of compulsions from other categories of repetitive behaviours, as well as the diagnostic weight assigned to compulsions in contemporary psychiatric diagnostic systems. We stress the importance of the feature of mental reflexivity for understanding the nature of insight and the ambiguous diagnostic status of poor insight in OCD which may be either a marker of the chronicity of obsessions, or a marker of their delusionality. Furthermore, we criticize two major shortcomings of contemporary psychiatric diagnostic systems(DSM-IV, DSM-V, ICD-10) in their criteria or guidelines for the diagnosis of OCD or OCS: first, the diagnostic parity between obsessions and compulsions and, second, the inadequate conceptualization of compulsions. We argue that these shortcomings might artificially inflate the clinical prevalence of OC symptoms in the course of schizophrenic disorders. Still, contrary to a recent proposal, we do not exclude on purely a priori grounds the possibility of a concurrence of genuine obsessions along with delusions in patients with schizophrenia.

Psychic euosmia and obsessive compulsive personality disorder

Patients with obsessive compulsive personality disorder(OCPD) often refer to a prompt mood improvement upon encountering good scents in general, or fresh laundry borax on their clothes, pillows or home settings. The Authors propose the new term psychic euosmia in the mean of an overstated psychological predisposition for a real pleasant smell that elicits an immediate sense of pleasure, order and calm. The prompt reactions to a pleasant odor might be explained by the involvement of rhinencephalon and its proximity to mood-related limbic circuits, which bypass the cognitive awareness. Cleanliness may not preclude a subject to enjoy a good smell, even if we are representing smells that resemble freshness, in other words order. A potentially even more important argument is given by the continuum of personality disorders and their variability. Not all personality characteristics led to disturbed behaviors. In evolutionary perspectives having the ability to differentiate between unpleasant and pleasant odors should have made the difference in surviving. On the other hand, psychic euosmia could be considered a normal reaction, but in our clinical experience it is over-represented among OCPD subjects with marked orderliness and disgust. Therefore, detecting psychic euosmia might vicariously confirm the relevance of disgust as a cognitive driver of OCPD. Hereby we support research to characterize psychic euosmia as a feature of orderliness and cleanliness for OCPD.

Influence of Withania somnifera on obsessive compulsive disorder in mice

Objective:To study the influence of methanolic and aqueous extract of Withania somnifera (W.somnifera) root on the marble-burying behavior of mice a well-accepted model of obsessive compulsive behavior.Methods:Mice were divided in different groups(n=6).Fluoxetine(5,10,15 mg/kg), (10,25,50,100 mg/kg) and melhanolic extract W.somnifera(MEWS)(10,25,50,100 mg/kg) were administered i.p.30 min.prior to the assessment of marble burying behavior and locomotor activity.The control group received vehicle of the extract.Results:Administration of aqueous extracts W.somnifera(AEWS) and MEWS(50 mg/kg) successively decreaesed the marble burying behavior activity without affecting motor activity.This effect of AEWS and MEWS was comparable to standard fluoxetine,ritanserin and parachlorophenylalanine.Conclusions:W.somnifera extract is effective in treating obsessive compulsive disorder.

Validation of Symptom Dimensions and Sub-Type Responses in Cognitive Behavioral Therapy in Obsessive Compulsive Disorder: A Systemic Review and Meta-Analysis

Background: Obsessive-compulsive disorder (OCD) is a clinically heterogeneous condition without a conclusivesubtype dimension. This study will focus on the meta-analysis of the clinical responses of OCD subtypes to cognitivebehavioral therapy (CBT), which might clarify this issue. Methods: We performed a systematic search and ameta-analysis for the studies of OCD subtypes and the response to CBT in PubMed, ScienceDirect, Embase, Webof Science, and Scopus databases. The selective criteria were the OCD without significant medical or psychiatricco-morbidities and pre-and post-treatment changes in scores of OCD dimension. In addition, different subtypesof OCD in symptom dimensions, such as symmetry, contamination, unacceptable thoughts, and hoarding, werecompared to find the most significant subtype using the treatment response parameters by CBT. After limitedselection, four studies and 479 OCD subjects were enrolled. The meta-analysis was performed by Review Manager5.4, and only significant results were reported. Results: Among the OCD subtypes, the meta-analysis favors thehoarding subtype with poorer responses to CBT than symmetry, contamination, and unacceptable thoughts.The meta-analysis results were negative mean differences, significant tests for overall effect, and limited heterogeneitiesin the random effects model. In addition, the results were more significant when the hoarding subtypewas compared with non-hoarding subtypes. Conclusion: The hoarding subtype might be the most significantrepresentative subtype of OCD symptom dimension under the impression of unfavorable clinical response toCBT. However, future studies with more treatment parameters will be warranted to confirm this finding.

Relationship between Obsessive-Compulsive Symptoms and Anxiety Levels during the COVID-19 Pandemic in Healthcare Professionals vs.Non-Healthcare Professionals

The present study investigated the effect of the COVID-19 pandemic on anxiety levels,contamination and responsibility/control obsessions and associated OC behaviors in healthcare versus non-healthcare professionals.The study also aimed to examine the relationship between anxiety levels and obsessive-compulsive(OC)symptom levels,gender,age,educational level,and personal and family history of chronic diseases.The 664 participants included 395(59.5%)men and 269(40.5%)women and comprised 180(27.1%)healthcare professionals and 484(72.9%)non-healthcare professionals.The survey included three data collection tools:(i)Sociodemographic data form,(ii)Beck Anxiety Inventory(BAI),and(iii)the Dimensional Obsessive-Compulsive Scale Abriged(DOCS-A)pre-and post-pandemic forms.The BAI scores established a moderate positive correlation with post-pandemic DOCS-A total scores and a weak positive correlation with pre-pandemic DOCS-A total scores(p<0.001 for both).Pre-and post-pandemic DOCS-A total and subdimension scores were significantly higher in women than in men(p<0.05).Participants with a personal history of chronic diseases had higher BAI and DOCS-A scores compared to participants with no such history(p<0.001 and p<0.001,respectively).The results indicated a significant increase in OC symptoms during the pandemic period compared to the pre-pandemic period and a moderate correlation between the anxiety levels and OC symptom severity.It was also revealed that female gender and personal or family history of chronic diseases posed a higher risk for the increase in anxiety and OC symptoms and healthcare professionals had a higher risk of developing anxiety symptoms compared to non-healthcare professionals.

Woman diagnosed with obsessive-compulsive disorder became delusional after childbirth:A case report

BACKGROUND Obsessive-compulsive disorder(OCD)is a common mental disorder that varies greatly in manifestation and causes much distress to individuals.We describe a case in which a Chinese woman with OCD became delusional after childbirth,and discuss the possible phenomenological and psychological alterations.CASE SUMMARY A 27-year-old woman presented to the Psychiatry Department of our hospital with obsessions and compulsions.After taking medication,her symptoms were alleviated.Three years later,during her pregnancy,the obsessions returned and even progressed into paranoid delusions after childbirth.After multiple adjustments of treatment along with several fluctuations,she finally achieved remission and gained reasonable insight.CONCLUSION This case suggests that the patient with OCD appeared to move along a continuum of beliefs,and highlights the importance of effective intervention during pregnancy,which would exert a significant impact on postpartum exacerbation outcomes.

Intrusive Thoughts and Executive Functions in Obsessive Compulsive Disorder

Objectives: Our aim was to compare the effects of an unwanted intrusive thought on executive function in a group of people with Obsessive Compulsive Disorder (OCD) and in a healthy group. Method: The Behavior Rating Inventory of Executive Function Adult (BRIEF-A) was used to measure executive dysfunction in everyday life in people with OCD. The study participants underwent either an intrusive thought induction or neutral thought induction prior to the administration of three computer-based tests of executive function. Results: The BRIEF-A results confirmed the impairment of executive function in everyday life for patients with OCD. In the number-letter task, patients with OCD displayed a longer reaction time (relative to the controls). There were no intergroup differences in the local-global task. In the go/no-go task, there was a significant impairment (p = 0.03) in the OCD group (with more commission errors than controls). There was a non-significant trend towards an effect of thought induction in both groups in the number-letter task. However, intrusive thought induction did not have a greater effect than neutral thought induction on the OCD group in any of the tasks. Conclusions: Intrusive thought induction has no effect on executive function in the two groups. The two groups differed with regard to two executive tasks.

Neuropsychological and Neurological Deficits in Obsessive-Compulsive Disorder: The Role of Comorbid Depression

Past research has found a high prevalence of neuropsychological deficits and neurological soft signs in patients with obsessive-compulsive disorder (OCD). A close relationship between OCD and depression has also been indicated in the literature. However, many aspects of this association remain unclear. In this study we compared neuropsychological functioning and neurological soft signs of 46 OCD patients who were off psychotropic medication (21 with significant depressive symptoms and 25 without) with 25 non-patient comparison subjects. The patients were matched to the comparison group with regard to age, sex, education, marital status and handedness. There were significant differences between OCD patients and the non-patient comparison group on neuropsychological functioning but not on neurological soft signs. As far as working memory concerns there was a significant difference between the OCD depressed and non-depressed groups. But we found no evidence that the neuropsychological functions such as cognitive flexibility, problem solving and spatial perception in OCD to be attributable to comorbid depression. The pattern of neuropsychological deficits in this sample of OCD patients is suggestive of orbito-frontal as well as dorsolateral prefrontal cortical dysfunction.

Broader Role for Antipsychotics in the Treatment of Obsessive Compulsive Disorder and Schizophrenia—A Malaysian Case Series

Obsessive compulsive disorder (OCD) and schizophrenia have been considered to be variants of the same disorder. At the advent of psychiatry, there was a distinction between neurotic, mood disorders and psychotic disorders. As perceptions and thoughts evolve in this dynamic field, there has been a paradigm shift in the way these disorders are being perceived. Of particular interest is that concerning OCD and schizophrenia. In a much anticipated and very welcomed move, DSM V has now included delusional beliefs as a specifier of OCD. However the much spoken about schizo- obsessive syndrome is yet to be explored and addressed. Recurrent and intrusive thoughts, impulses and images are key experiences seen in OCD. How we differentiate these vivid images from visual hallucination is a question yet to be answered. The following case series is an example of how difficult the boundaries between severe OCD and schizophrenia can be, and the promising usage of atypical antipsychotic in controlling obsessive compulsive symptoms. Whether untreated OCD is a significant prodromal symptom of schizophrenia, a subtype of schizophrenia or an initial indicator of various syndromes, remains to be seen, depending on environmental effects on the neuroplasticity of the mind and brain. The cases discussed will highlight the role of antipsychotics in patients diagnosed as having OCD, and gives strength to the idea that perhaps antipsychotics should be used more liberally in the treatment of OCD in schizophrenia. Here, we present a case series to show the use of atypical antipsychotics as monotherapy or augmenter in quelling obsessive-compulsive symptoms in patients who fulfilled the DSM V criteria for both schizophrenia and OCD. The efficacy of antipsychotics in reducing OCD symptoms in psychotic patients, as shown in this case series, contributes to the body of evidence that OCD and schizophrenia are really spectrum disorders with a common denominator. It is hoped that this exciting finding will lead to a paradigm shift in the usage of antipsychotics in OCD and eventually change how this disease is viewed and treated.

The Obsessive Compulsive Disorder Symptoms after the Successful Treatment of the Pineal Germinoma： A Case Report

We report here, a young male patients referred with ＂Obsessive Compulsive Disorder＂ symptoms which emerged after the successful treatment of pineal germinoma. OCD （obsessive-compulsive disorder） is a frequent, chronic, and clinically disorder which may presents in several neurologic disorders, especially occurs, in early adult life. Essential features of OCD are obsessional thoughts, compulsive acts as the ritualistic behavior, anxiety, and specific cognitive impairments. The cause of obsessive-compulsive disorder isn＇t fully understood. One of the many theories of the pathophysioiogy about to OCD is includes with hyperactivity in certain subcortical and cortical regions of brain also, dysfunction of the cortico-striatal circuits, particularly implicated in orbitofrontal cortices and basal ganglions. Additionally, pineal gland functioning is remarkable for the mental health disorders, particularly in OCD. On the basis of the investigations to present case report, we discussed the probable reasons of OCD symptoms, emphasizing the role of pathophysiology including the cortico subcortical pathways in genesis of the symptoms.

Dissociative symptoms and dissociative disorders comorbidity in obsessive compulsive disorder: Symptom screening, diagnostic tools and reflections on treatment

Borderline personality disorder, conversion disorder and obsessive compulsive disorder frequently have dissociative symptoms. The literature has demonstrated that the level of dissociation might be correlated with the severity of obsessive compulsive disorder(OCD) and that those not responding to treatment had high dissociative symptoms. The structured clinical interview for DSM-IV dissociative disorders, dissociation questionnaire, somatoform dissociation questionnaire and dissociative experiences scale can be used for screening dissociative symptoms and detecting dissociative disorders in patients with OCD. However, a history of neglect and abuse during childhood is linked to a risk factor in the pathogenesis of dissociative psychopathology in adults. The childhood trauma questionnaire-53 and childhood trauma questionnaire-40 can be used for this purpose. Clinicians should not fail to notice the hidden dissociative symptoms and childhood traumatic experiences in OCD cases with severe symptoms that are resistant to treatment. Symptom screening and diagnostic tools used for this purpose should be known. Knowing how to treat these pathologies in patients who are diagnosed with OCD can be crucial.

Exploring the Reasons for Selfie-Taking and Selfie-Posting on Social Media with Its Effect on Psychological and Social Lives:A Study among Indian Youths

‘Selfie’taking was introduced to the common people by smartphones and has become a common practice across the globe in no time.With technological advancement and the popularity of smartphones,selfie-taking has grown rapidly within a short time.In light of the new trend set by the generation,this study aimed to explore reasons for selfie-taking and selfie-posting on social media and their effects on the social and psychological lives of young adults.A purposive sampling method was adopted to select 20 Indian citizens,between 18 and 24 years.The data were collected through semi-structured interviews and analysed using thematic analysis.Selfie-taking and posting on social media give positive feelings,and it acts as a mood modifier dependent mostly on the favourability and feedback about the post which in turn affects emotions and self-satisfaction.

Evaluating Pharmacological and Rehabilitation Strategies for Effective Management of Bipolar Disorder: A Comprehensive Clinical Study

Bipolar disorder presents significant challenges in clinical management, characterized by recurrent episodes of depression and mania often accompanied by impairment in functioning. This study investigates the efficacy of pharmacological interventions and rehabilitation strategies to improve patient outcomes and quality of life. Utilizing a randomized controlled trial with multiple treatment arms, participants will receive pharmacotherapy, polypharmacotherapy, rehabilitation interventions, or combination treatments. Outcome measures will be assessed using standardized scales, including the Hamilton Depression Scale, Yale-Brown Obsessive Compulsive Scale (Y-BOCS), and Mania Scale. Preliminary data suggest improvements in symptom severity and functional outcomes with combination treatments. This research aims to inform clinical practice, guide treatment decisions, and ultimately enhance the quality of care for individuals living with bipolar disorder. Findings will be disseminated through peer-reviewed journals and scientific conferences to advance knowledge in this field.

The Association between Fear of COVID-19,Obsession with COVID-19,and Post Traumatic Stress Disorder in Korean Emergency Rescue Firefighters:A Cross-Sectional Study

During the rapid spread of COVID-19,first responders are at risk of being exposed to COVID-19 due to their role in providing first aid and responding to an unspecified number of people.This uncertainty can have adverse mental health effects,such as increased anxiety and fear.This study aimed to investigate the degree of association between fear of COVID-19,obsession with COVID-19,and post-traumatic stress disorder(PTSD)in emergency rescue firefighters.The participants were 150 emergency rescue firefighters working in Region S,Korea.They filled out self-report questionnaires:The data obtained through the Fear of COVID-19 Scale,Obsession with COVID-19 Scale,and Impact of Event Scale-Revised Korean version were subjected to nonparametric statistical analysis using SPSS WIN 25.0.The study found a significant correlation between emergency rescue firefighters’fear of COVID-19,obsession with COVID-19,and PTSD.Fear and obsession with COVID-19 were higher among first responder firefighters who were directly involved in COVID-19-related tasks.Furthermore,a one-point increase in obsession was associated with a 2.837-point increase in PTSD.Based on the results,we found that there is a need for effective control of obsessions and fears among first responder firefighters during COVID-19,and we suggest that there is a need for mental health care for first responder firefighters during the pandemic through the development and support of programs to prevent and mitigate obsessions.

NO ASSOCIATION BETWEEN TUMOR NECROSIS FACTOR ALPHA AND OBSESSIVE COMPULSIVE DISORDER IN CHINESE HAN POPULATION

Objective To investigate association between tumor necrosis factor alpha (TNF-α) and obsessive compulsive disorder (OCD) in Chinese Han population.Methods Plasma concentrations of TNF-α were measured in 61 drug-free patients who fulfilled DSM-Ⅳ criteria for OCD and 93 healthy controls.TNF-α concentrations in blood were determined by enzyme-linked immunosorbent assay (ELISA).Two polymorphisms of TNF-α gene were investigated in the same patients and healthy controls:-308 G/A and-238 G/A.The allelic and genotypic frequencies of these polymorphisms were examined by using DNA sequencing method.Results Plasma levels of TNF-α did not differ between patients and controls (P=0.292).No significant results were observed for any of the alleles at the-308 G/A or-238 G/A polymorphism of the TNF-α gene.Finally a haplotype consisting of genotypes of these two markers was also examined.No association was observed for any haplotype (P=0.108).Conclusion No significant differences were observed between patients and controls in plasma levels of TNF-α.There is no association between the-308 G/A and-238 G/A TNF-α gene polymorphisms and OCD in our Chinese samples.However,the results need to be replicated in larger samples.

Rapunzel syndrome is not just a mere surgical problem: A case report and review of current management

Recurrent Rapunzel syndrome(RRS) is a rare clinical presentation with fewer than six cases reported in the Pub Med literature. A report of RRS and literature review is presented. A 25-year-old female was admitted to hospital with a 4-wk history of epigastric pain and swelling. She had a known history of trichophagia with a previous admission for Rapunzel syndrome requiring a laparotomy nine years earlier, aged 16. Psychological treatment had been successfully achieved for nine years with outpatient hypnotherapy sessions only, but she defaulted on her last session due to stressors at home. The abdominal examination demonstrated an epigastric mass. Computer tomography scan revealed a large gastric bezoar and features of aspiration pneumonia. The patient underwent emergency open surgical laparotomy for removal as the bezoar could not be removed endoscopically. The bezoar was cast in a shape that mimicked the contours of the stomach and proximal small bowel, hence the diagnosis of RRS. The patient was seen by a psychiatrist and was commenced on Quetiapine before discharge. She continues to attend follow-up.

A neuropsychological evaluation of orthorexia nervosa

Orthorexia nervosa (ON) describes a fixation for proper nutrition and healthy foods that leads to die-tary restrictions and nutritional deficiencies over time. Given symptom overlap among ON, obsessive-compulsive disorder (OCD), and anorexia nervosa (AN), this study examines whether ON has a unique neuropsychological profile. Participants completed symptom checklists and neuropsychological tests chosen for their sensitivity to AN and OCD. Results showed that, across the full sample, ON is independently associated with self-reported weaknesses in Set-Shifting, Emotional Control, Self-Monitoring, and Working Memory. After controlling for AN and OCD variables, high- and low-ON groups differed in total correct trials on the Wisconsin Card Sorting Test. These areas of executive functioning, which are explained in the context of ON symptomatology, represent what would be considered the neuropsychological overlap among OCD and AN profiles.