Neuropsychological functioning in obsessive-compulsive disorder: Are executive functions the key deficit?

• Published in: Comprehensive psychiatry Vol. 54; no. 5; pp. 533 - 540
• Main Authors: Kashyap, Himani, Kumar, J. Keshav, Kandavel, Thennarasu, Reddy, Y.C. Janardhan
• Format: Journal Article
• Language: English
• Published: New York, NY Elsevier Inc 01.07.2013; Elsevier; Elsevier Limited
• Subjects: Adolescent; Adult; Adult and adolescent clinical studies; Anxiety disorders. Neuroses; Biological and medical sciences; Bipolar disorder; Cognition & reasoning; Concept Formation; Decision Making; Executive Function; Female; Humans; Male; Medical sciences; Memory; Neuropsychological Tests; Neuroses; Obsessive compulsive disorder; Obsessive-Compulsive Disorder - psychology; Obsessive-compulsive disorders; Psychiatry; Psychology. Psychoanalysis. Psychiatry; Psychopathology. Psychiatry; Studies; Obsessive compulsive disorder; Psychometrics; Executive function; Cognition; Anxiety disorder; Neuropsychological test
• ISSN: 0010-440X; 1532-8384
• DOI: 10.1016/j.comppsych.2012.12.003

Abstract Objective Although several studies have examined neuropsychological functions in obsessive-compulsive disorder (OCD), findings are not conclusive, predominantly due to small samples and assessment of limited domains. We aim to map the neuropsychological profile of OCD in a large sample with a comprehensive battery of tests. Method Neuropsychological functions were tested in 150 subjects with DSM-IV OCD and 205 healthy control subjects. Results Subjects with OCD performed significantly worse than healthy control subjects on Colour Trails 1 time, Tower of Hanoi 3-disk time, Wisconsin Card Sorting Test categories completed, Iowa Gambling Task, Complex Figure Test immediate and delayed recall (p < 0.001). Conclusions Subjects with OCD evince deficits in scanning, planning time, concept formation, decision making and encoding of non-verbal memory after controlling for the effects of age, gender and education. The profile is suggestive of a predominantly executive dysfunction, with difficulties in strategizing and organizing stimuli and cognitive resources for maximum efficiency. The findings implicate dorsolateral prefrontal, superior medial prefrontal and anterior cingulate cortices, suggesting that OCD might not be a purely orbitofronto-striatal disorder as previously conceptualized.