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The place of obsessive–compulsive and related disorders in the compulsive–impulsive spectrum: a cluster-analytic study

Published online by Cambridge University Press:  12 April 2021

Leonardo F. Fontenelle Open the ORCID record for Leonardo F. Fontenelle [Opens in a new window] ,
Louise Destrée ,
Mary-Ellen Brierley ,
Emma M. Thompson ,
Murat Yücel ,
Rico Lee ,
Lucy Albertella Open the ORCID record for Lucy Albertella [Opens in a new window]  and
Sam R. Chamberlain Open the ORCID record for Sam R. Chamberlain [Opens in a new window]
Leonardo F. Fontenelle*
Affiliation:
Turner Institute for Brain and Mental Health, Monash University, Clayton, Victoria, Australia Obsessive, Compulsive, and Anxiety Spectrum Research Program, Institute of Psychiatry, Federal University of Rio de Janeiro (UFRJ) D’Or Institute for Research and Education (IDOR), Rio de Janeiro, Brazil
Louise Destrée
Affiliation:
Turner Institute for Brain and Mental Health, Monash University, Clayton, Victoria, Australia
Mary-Ellen Brierley
Affiliation:
Turner Institute for Brain and Mental Health, Monash University, Clayton, Victoria, Australia
Emma M. Thompson
Affiliation:
Turner Institute for Brain and Mental Health, Monash University, Clayton, Victoria, Australia
Murat Yücel
Affiliation:
Turner Institute for Brain and Mental Health, Monash University, Clayton, Victoria, Australia
Rico Lee
Affiliation:
Turner Institute for Brain and Mental Health, Monash University, Clayton, Victoria, Australia
Lucy Albertella
Affiliation:
Turner Institute for Brain and Mental Health, Monash University, Clayton, Victoria, Australia
Sam R. Chamberlain
Affiliation:
Department of Psychiatry, University of Southampton; and Department of Psychiatry, University of Cambridge, UK
*
*Author for correspondence: Leonardo F. Fontenelle, MD, PhD Email: lfontenelle@gmail.com
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Abstract

Background

The extent to which obsessive–compulsive and related disorders (OCRDs) are impulsive, compulsive, or both requires further investigation. We investigated the existence of different clusters in an online nonclinical sample and in which groups DSM-5 OCRDs and other related psychopathological symptoms are best placed.

Methods

Seven hundred and seventy-four adult participants completed online questionnaires including the Cambridge–Chicago Compulsivity Trait Scale (CHI-T), the Barratt Impulsiveness Scale (BIS-15), and a series of DSM-5 OCRDs symptom severity and other psychopathological measures. We used K-means cluster analysis using CHI-T and BIS responses to test three and four factor solutions. Next, we investigated whether different OCRDs symptoms predicted cluster membership using a multinomial regression model.

Results

The best solution identified one “healthy” and three “clinical” clusters (ie, one predominantly “compulsive” group, one predominantly “impulsive” group, and one “mixed”—“compulsive and impulsive group”). A multinomial regression model found obsessive–compulsive, body dysmorphic, and schizotypal symptoms to be associated with the “mixed” and the “compulsive” clusters, and hoarding and emotional symptoms to be related, on a trend level, to the “impulsive” cluster. Additional analysis showed cognitive-perceptual schizotypal symptoms to be associated with the “mixed” but not the “compulsive” group.

Conclusions

Our findings suggest that obsessive–compulsive disorder; body dysmorphic disorder and schizotypal symptoms can be mapped across the “compulsive” and “mixed” clusters of the compulsive–impulsive spectrum. Although there was a trend toward hoarding being associated with the “impulsive” group, trichotillomania, and skin picking disorder symptoms did not clearly fit to the demarcated clusters.

Keywords

Compulsivityimpulsivityobsessive–compulsive disorderbody dysmorphic disorderhoarding disordertrichotillomania
Type
Original Research
Information
CNS Spectrums , Volume 27 , Issue 4 , August 2022 , pp. 486 - 495
Copyright
© The Author(s), 2021. Published by Cambridge University Press

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Footnotes

Lucy Albertella and Sam R. Chamberlain shared last authorship.

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