The relationship between cognitive phenotypes of compulsivity and impulsivity and clinical variables in obsessive-compulsive disorder: A systematic review and Meta-analysis

• Published in: Comprehensive psychiatry Vol. 133; p. 152491
• Main Authors: Clarke, Aaron T., Fineberg, Naomi A., Pellegrini, Luca, Laws, Keith R.
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.08.2024; Elsevier Limited; Elsevier
• Subjects: Body dysmorphic disorder; Cognition; Cognitive ability; Comorbidity; Compulsive Behavior - diagnosis; Compulsive Behavior - psychology; compulsivity; Decision making; executive function; Gambling; Humans; Impulsive Behavior; Impulsivity; latent phenotype; Mental disorders; Meta-analysis; Neurobiology; Neurosciences; Neuroses; Obsessive compulsive disorder; Obsessive-Compulsive Disorder - diagnosis; Obsessive-Compulsive Disorder - psychology; OCD; Phenotype; Systematic review; United States > US; Iowa; Wisconsin; impulsivity; OCD; compulsivity; latent phenotype; executive function
• ISSN: 0010-440X; 1532-8384; 1532-8384
• DOI: 10.1016/j.comppsych.2024.152491

This systematic review and meta-analysis explored the relationship between cognitive phenotypes of compulsivity and impulsivity and clinical variables in obsessive-compulsive disorder (OCD). We searched Pubmed, Scopus, Cochrane Library and PsychINFO databases until February 2023 for studies comparing patients with OCD and healthy controls on cognitive tests of compulsivity and impulsivity. The study followed PRISMA guidelines and was pre-registered on PROSPERO (CRD42021299017). Meta-analyses of 112 studies involving 8313 participants (4289 patients with OCD and 4024 healthy controls) identified significant impairments in compulsivity (g = −0.58, [95%CI -0.68, −0.47]; k = 76) and impulsivity (g = −0.48, [95%CI -0.57, −0.38]; k = 63); no significant difference between impairments. Medication use and comorbid psychiatric disorders were not significantly related to impairments. No associations were revealed with OCD severity, depression/anxiety, or illness duration. Cognitive phenotypes of compulsivity and impulsivity in patients with OCD appear to be orthogonal to clinical variables, including severity of OCD symptomatology. Their clinical impact is poorly understood and may require different clinical assessment tools and interventions. •Comparable moderate impairments of neurocognitive compulsivity and impulsivity occur in patients with OCD.•Both motor and decision-making impulsivity are impaired in patients with OCD.•Compulsivity and impulsivity deficits are unrelated to clinical variables•These cognitive impairments in OCD appear to be latent trait phenomena that remain untouched by current treatments.