Deconstructing obsessive-compulsive disorder: a multidimensional perspective. 2006

David Mataix-Cols
Departments of Psychological Medicine and Psychology, Institute of Psychiatry, King's College London, London, UK. d.mataix@iop.kcl.ac.uk

OBJECTIVE The aim of this article is to critically summarize the most promising attempts to split obsessive-compulsive disorder into subgroups based on clinical characteristics (i.e. age of onset, presence of comorbid tics, positive family history) and symptom theme, with particular emphasis on the latter. RESULTS Attempts to split obsessive-compulsive disorder into mutually exclusive sub-groups based on clinical characteristics have been useful but not exempt of problems. The complex clinical presentation of the condition can be reduced to a few consistent, temporally stable symptom dimensions that can coexist in any given individual. Researchers have begun to investigate the genetics and neural mechanisms of these symptom dimensions and to develop specific assessment and treatment protocols for each particular problem. CONCLUSIONS The multidimensional model of obsessive-compulsive disorder proposes a middle ground between the 'lumping' and 'splitting' perspectives. The disorder can be better understood as a spectrum of multiple potentially overlapping syndromes. The most fruitful research strategy will be to examine the common and specific etiological factors implicated in each symptom dimension.

UI MeSH Term Description Entries
D009771 Obsessive-Compulsive Disorder An anxiety disorder characterized by recurrent, persistent obsessions or compulsions. Obsessions are the intrusive ideas, thoughts, or images that are experienced as senseless or repugnant. Compulsions are repetitive and seemingly purposeful behavior which the individual generally recognizes as senseless and from which the individual does not derive pleasure although it may provide a release from tension. Anankastic Personality,Neurosis, Obsessive-Compulsive,Anankastic Personalities,Disorder, Obsessive-Compulsive,Disorders, Obsessive-Compulsive,Neuroses, Obsessive-Compulsive,Neurosis, Obsessive Compulsive,Obsessive Compulsive Disorder,Obsessive-Compulsive Disorders,Obsessive-Compulsive Neuroses,Obsessive-Compulsive Neurosis,Personalities, Anankastic,Personality, Anankastic
D001921 Brain The part of CENTRAL NERVOUS SYSTEM that is contained within the skull (CRANIUM). Arising from the NEURAL TUBE, the embryonic brain is comprised of three major parts including PROSENCEPHALON (the forebrain); MESENCEPHALON (the midbrain); and RHOMBENCEPHALON (the hindbrain). The developed brain consists of CEREBRUM; CEREBELLUM; and other structures in the BRAIN STEM. Encephalon
D003937 Diagnosis, Differential Determination of which one of two or more diseases or conditions a patient is suffering from by systematically comparing and contrasting results of diagnostic measures. Diagnoses, Differential,Differential Diagnoses,Differential Diagnosis
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D049268 Positron-Emission Tomography An imaging technique using compounds labelled with short-lived positron-emitting radionuclides (such as carbon-11, nitrogen-13, oxygen-15 and fluorine-18) to measure cell metabolism. It has been useful in study of soft tissues such as CANCER; CARDIOVASCULAR SYSTEM; and brain. SINGLE-PHOTON EMISSION-COMPUTED TOMOGRAPHY is closely related to positron emission tomography, but uses isotopes with longer half-lives and resolution is lower. PET Imaging,PET Scan,Positron-Emission Tomography Imaging,Tomography, Positron-Emission,Imaging, PET,Imaging, Positron-Emission Tomography,PET Imagings,PET Scans,Positron Emission Tomography,Positron Emission Tomography Imaging,Positron-Emission Tomography Imagings,Scan, PET,Tomography Imaging, Positron-Emission,Tomography, Positron Emission

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