Skip to main content Accessibility help
×
Home

Impaired executive functions in paediatric obsessive-compulsive disorder patients

  • Yasemen Isık Taner (a1), Emel Erdogan Bakar (a2) and Ozgur Oner (a3)

Extract

Isık Taner Y, Erdogan Bakar E, Oner O. Impaired executive functions in paediatric obsessive-compulsive disorder patients.

Objective: There are only few studies which investigated the neuropsychological performances of paediatric patients with obsessive-compulsive disorder (OCD). Previous studies show that most of adult OCD patients had an onset of their first symptoms before the age of 15. Our objective was to evaluate the neuropsychological functions in paediatric patients with OCD.

Methods: We compared the executive functions and general intelligence of child and adolescent OCD patients (n = 20) with age- and gender-matched healthy controls (n = 20). To compare mentioned skills, a neuropsychological test battery including Wechsler Intelligence Scale for Children-Revised (WISC-R), Wisconsin Card Sorting Test (WCST), Stroop Test and Verbal Fluency Test was performed.

Result: Performances of the OCD and control subjects on neuropsychological tests were statistically analysed by using multivariate analysis of covariance (MANCOVA), in which Full Scale Intelligence Quotient (FSIQ) results were taken into consideration as a covariate to observe FSIQ's effect on test scores. Our results showed that the differences in WISC-R Picture Arrangement and Coding scores remained significant when co-analysed with FSIQ scores. In a similar manner, the OCD group exhibited worse performances on STR1-duration, STR3-duration, STR3-error, STR4-duration, STR4-error, STR5-correct response, and STR5-error as compared with the control group when FSIQ scores were taken into calculation. Some variables of the WCST (perseverative responses, percent errors, abstraction-flexibility and categories completed) also yield lower test scores in the OCD group. There was no significant difference between the groups regarding Verbal Fluency Test scores.

Conclusion: Our results suggested that paediatric OCD patients had worse abstraction-flexibility, mental set-shifting, verbal comprehension and visuospatial/construction abilities.

Copyright

Corresponding author

Dr Emel Erdoğan Bakar, Department of Psychology, Ufuk University, Doktor Sadik Akin Caddesi No 35, Ek Bina:3 06520-Balgat, Ankara, Turkey. Tel: +90 532 559 7901; Fax: +90 312 286 2395; E-mail: bulentbanrs@yahoo.com

References

Hide All
1.Alsobrook, JP, Leckman, JF, Goodman, WK, Rasmussen, SA, Pauls, DL.Segregation analysis of obsessive-compulsive disorder using symptom-based factor scores. Am J Med Genet 1999;88:669675.
2.Rosenberg, DR, Keshavan, MS.Toward a neurodevelopmental model of obsessive-compulsive disorder. Biol Psychiatry 1998;43:623640.
3.Geller, DA, Biederman, J, Faraone, S et al. Developmental aspects of obsessive compulsive disorder: findings in children, adolescents, and adults. J Nerv Ment Dis 2001;189:471477.
4.Savage, CR, Deckersbach, T, Wilhelm, S et al. Strategic processing and episodic memory impairment in obsessive compulsive disorder. Neuropsychology 2000;14:141151.
5.Penadés, R, Catalán, R, Andrés, S, Salamero, M, Gastó, C.Executive function and nonverbal memory in obsessive-compulsive disorder. Psychiatry Res 2005;133:8190.
6.Behar, D, Rapoport, JL, Berg, CJ et al. Computerized tomography and neuropsychological test measures in adolescents with obsessive compulsive disorder. Am J Psychiatry 1984;141:363369.
7.Cox, CS, Fedio, P, Rapoport, JL. Neuropsychological testing of obsessive ± compulsive adolescents. In: Rapoport, JL, ed. Obsessive ± compulsive disorder in children and adolescents. Washington: American Psychiatric Press, 1989: 7385.
8.Andrés, S, Lázaro, L, Salamero, M, Boget, T, Penadés, R, Castro-Fornieles, J.Changes in cognitive dysfunction in children and adolescents with obsessive-compulsive disorder after treatment. J Psychiatr Res 2008;42:507514.
9.Irak, M, Flament, MF.Neuropsychological profile of childhood-onset obsessive-compulsive disorder. Turk Psikiyatri Derg 2007;18:293301.
10.Diniz, JB, Rosario-Campos, MC, Shavitt, RG et al. Impact of age at onset and duration of illness on the expression of comorbidities in obsessive-compulsive disorder. J Clin Psychiatry 2004;65:2227.
11.Kuelz, AK, Hohagen, F, Voderholzer, U.Neuropsychological performance in obsessive-compulsive disorder: a critical review. Biol Psychol 2004;65:185236.
12.Moritz, S, Jacobsen, D, Kloss, M, Fricke, S, Rufer, M, Hand, I.Examination of emotional Stroop interference in obsessive-compulsive disorder. Behav Res Ther. 2004;42: 671682.
13.Constans, JI, Foa, EB, Franklin, ME, Mathews, A.Memory for actual and imagined events in OC checkers. Behav Res Ther 1995;33:665671.
14.Randomsky, AS, Rachman, S.Memory bias in obsessive compulsive disorder (OCD). Behav Res Ther 1999;37: 605618.
15.Radomsky, AS, Rachman, S, Hammond, D.Memory bias, confidence and responsibility in compulsive checking. Behav Res Ther 2001;39:813822.
16.Ceschi, G, Van der Linden, M, Dunker, D, Perroud, A, Brédart, S.Further exploration memory bias in compulsive washers. Behav Res Ther 2003;41:737748.
17.MacDonald, PA, Antony, MM, Macleod, CM, Richter, MA.Memory and confidence in memory judgements among individuals with obsessive compulsive disorder and non-clinical controls. Behav Res Ther 1997;35:497505.
18.Tolin, DF, Abramowitz, JS, Brigidi, BD, Amir, N, Street, GP, Foa, EB.Memory and memory confidence in obsessive-compulsive disorder. Behav Res Ther 2001;39:913927.
19.Flament, MF, Koby, E, Rapoport, JL, et al. Childhood obsessive-compulsive disorder: a prospective follow-up study. J Child Psychol Psychiatry 1990;31:363380.
20.Cox, C.Neuropsychological abnormalities in obsessive compulsive disorder and their assessments. Int Rev Psychiatry 1997;9:4559.
21.Abbruzzese, M, Ferri, S, Scarone, S.The selective breakdown of frontal functions in patients with obsessive-compulsive disorder and in patients with schizophrenia: a double dissociation experimental finding. Neuropsychologia 1997;35:907912.
22.Bohne, A, Savage, CR, Deckersbach, T et al. Visuospatial abilities, memory, and executive functioning in trichotillomania and obsessive compulsive disorder. J Clin Exp Neuropsychol 2005;27:385399.
23.Moritz, S, Fricke, S, Wagner, M, Hand, I.Further evidence for delayed alternation deficits in obsessive-compulsive disorder. J Nerv Ment Dis 2001;189:562564.
24.Cavedini, P, Ferri, S, Scarone, S, Bellodi, L.Frontal lobe dysfunction in obsessive-compulsive disorder and major depression: a clinical neuropsychological study. Psychiatry Res 1998;78:2128.
25.Rowe, JB, Owen, AM, Johnsrude, IS, Passingham, RE.Imaging the mental components of a planning task. Neuropsychologia 2001;39:315327.
26.Spitznagel, MB, Suhr, JA.Executive function deficits associated with symptoms of schizotypy and obsessive-compulsive disorder. Psychiatry Res 2002;110:151163.
27.Beers, SR, Rosenberg, DR, Dick, EL et al. Neuropsychological study of frontal lobe function in psychotropic-naive children with obsessivecompulsive disorder. Am J Psychiatry 1999;156:777779.
28.Simpson, HB, Rosen, W, Huppert, JD, Lin, SH, Foa, EB, Liebowitz, MR.Are there reliable neuropsychological deficits in obsessive-compulsive disorder? J Psychiatr Res 2006;40:247257.
29.Insel, TR.Toward a neuroanatomy of obsessive-compulsive disorder. Arch Gen Psychiatry 1992;49:739744.
30.Fitzgerald, KD, Welsh, RC, Gehring, WJ et al. Error-related hyperactivity of the anterior cingulate cortex in obsessive-compulsive disorder. Biol Psychiatry 2005;57: 287294.
31.Aouizerate, B, Guehl, D, Cuny, E et al. Pathophysiology of obsessive-compulsive disorder: a necessary link between phenomenology, neuropsychology, imagery and physiology. Prog Neurobiol 2004;72:195221.
32.Henry, JD.A meta-analytic review of Wisconsin Card Sorting Test and verbal fluency performance in obsessive-compulsive disorder. Cogn Neuropsychiatry 2006;11: 156176.
33.Shin, MS, Choi, H, Kim, H, Hwang, JW, Kim, BN, Cho, SC.A study of neuropsychological deficit in children with obsessive-compulsive disorder. Eur Psychiatry 2008;23: 512520.
34.Stuss, DT, Benson, DF.The frontal lobes. New York: Raven, 1986.
35.Tallis, F.The neuropsychology of obsessive-compulsive disorder: a review and consideration of clinical implications. Br J Clin Psychol 1997;36:320.
36.Andrés, S, Boget, T, Lázaro, L et al. Neuropsychological performance in children and adolescents with obsessive-compulsive disorder and influence of clinical variables. Biol Psychiatry 2007;61:946951.
37.Gladstone, M, Carter, AS, Schultz, RT, Riddle, M, Scahill, L, Pauls, DL.Neuropsychological functioning of children affected with Tourette syndrome and obsessive ± compulsive disorder. J Clin Exp Neuropsychol 1993;15:70.
38.Douglass, HM, Moffitt, TE, Dar, R, McGee, R, Silva, P.Obsessive-compulsive disorder in a birth cohort of 18-year-olds: prevalence and predictors. J Am Acad Child Adolesc Psychiatry 1995;34:14241431.
39.Kaufman, J, Birmaher, B, Brent, D et al. Schedule for Affective Disorders and Schizophrenia for School-Age Children-Present and Lifetime Version (KSADS-PL): initial reliability and validity data. J Am Acad Child Adolesc Psychiatry 1997;36:980988.
40.Gökler, B, ÜNal, F, Pehlivantürk, F, Kültür, , Akdemir, D, Taner, Y.Reliability and Validity of Schedule for Affective Disorders and Schizophrenia for School Age Children-Present and Lifetime Version-Turkish Version (K-SADS-PL-T). Çocuk Gençlik Ruh Sağlığı Dergisi 2004; 11:109116.
41.Savasır, I, Sahin, N.Wechsler Çocuklar Icin Zeka Ölçeği (WISC-R) El Kitabı. Ankara: Türk Psikologlar Derneği Yayınları, 1995.
42.Karakaş, S, Erdoğan, E, Sak, L, Soysal, , Ulusoy, T, Yüceyurt, İ.Stroop Test-TBAG Form: standardisation for Turkish culture, reliability and validity. Clin Psychiatry 1999;2:7588.
43.Karakas, S.BILNOT Bataryası El Kitabı: Nöropsikolojik Testler için Arastırma ve Gelistirme Çalısmaları (2. baskı). Ankara: Eryılmaz Offset Matbaacılık Gazetecilik, 2006.
44.van Mourik, R, Oosterlaan, J, Sergeant, JA.The Stroop revisited: a meta-analysis of interference control in AD/HD. J Child Psychol Psychiatry 2005;46:150165.
45.Heaton, RK, Chelune, GJ, Talley, JL, Kay, GG, Curtiss, G.Wisconsin Card Sorting Test Manual, Revised and Expanded. Odessa: Psychological Assessment Resources, 1993.
46.Parker, DM, Crawford, JR. Assessment of frontal lobe dysfunction. In Crawford, JR, McKinlay, W, Parker, DM, eds. Handbook of neuropsychological assessment. Hove: Erlbaum and Associates, 1992: 267291.
47.Howienson, DB, Lezac, MD, Loring, DW.Neuropsychological assessment. Oxford: Oxford University Press, 2004: 696.
48.Burke, DM, Light, LL.Memory and aging: the role of retrieval processes. Psychol Bull 1981;90:513546.
49.Stuss, DT, Benson, DF.Neuropsychological studies of the frontal lobes. Psychol Bull 1984;95:328.
50.Brown, GG, Kindermann, SS, Siegle, GJ, Granholm, E, Wong, EC, Buxton, RB.Brain activation and pupil response during covert performance of the Stroop Color Word task. J Int Neuropsychol Soc 1999;5:308319.
51.Bush, G, Whalen, PJ, Rosen, BR, Jenike, MA, McInerney, SC, Rauch, SL.The counting Stroop: an interference task specialized for functional neuroimaging: validation study with functional MRI. Hum Brain Mapp 1998;6:270282.
52.Leung, HC, Skudlarski, P, Gatenby, JC, Peterson, BS, Gore, JC.An event related functional MRI study of the Stroop Color Word interference task. Cereb Cortex 2000;10:552560.
53.Fitzgerald, KD, Welsh, RC, Gehring, WJ et al. Error related hyperactivity of the anterior cingulate cortex in obsessive-compulsive disorder. Biol Psychiatry 2005;57: 287294.
54.Cavedini, P, Riboldi, G, D'Annucci, A, Belotti, P, Cisima, M, Bellodi, L.Decision-making heterogeneity in obsessive-compulsive disorder: ventromedial prefrontal cortex function predicts different treatment outcomes. Neuropsychologia 2002;40:205211.
55.Chamberlain, SR, Fineberg, NA, Blackwell, AD, Clark, L, Robbins, TW, Sahakian, BJ.A neuropsychological comparison of obsessive-compulsive disorder and trichotillomania. Neuropsychologia 2007;45:654662.
56.Chamberlain, SR, Fineberg, NA, Menzies, LA et al. Impaired cognitive flexibility and motor inhibition in unaffected first-degree relatives of patients with obsessive-compulsive disorder. Am J Psychiatry 2007;164:335338.
57.Pennington, BF, Ozonoff, S.Executive functions and developmental psychopathology. J Child Psychol Psychiatry 1996;37:5187.
58.Cummings, JL.Anatomic and behavioral aspect of frontal-subcortical circuits. Annu N Y Acad Sci 1995;769:113.
59.Drewe, EA.The effect or type and area of brain lesion on Wisconsin Card Sorting Test performance. Cortex 1974;10:15891670.
60.Nelson, HE.A modified Card Sorting Test sensitive to frontal lobe damage. Cortex 1976;12:313324.
61.Phelps, EA, Hyder, F, Blamire, AM, Shulman, RG.FMRI of the prefrontal cortex during overt verbal fluency. NeuroReport 1997;8:561565.
62.Pujol, J, Vendrell, P, Deus, J et al. Frontal lobe activation during word generation studied by functional MRI. Acta Neurologica Scandinavica 1996;93:403410.
63.Gambini, O, Abbruzzese, M, Scarone, S.Smooth pursuit and saccadic eye movements and Wisconsin Card Sorting Test performance in obsessive-compulsive disorder. Psychiatry Res 1993;48:191200.
64.Head, D, Bolton, D, Hymas, N.Deficit in cognitive shifting ability in patients with obsessive compulsive disorder. Biol Psychiatry 1989;25:929937.
65.Hymas, N, Lees, A, Bolton, D, Epps, K, Head, D.The neurology of obsessional slowness. Brain 1991;114:22032233.
66.Boone, KB, Ananth, J, Philpott, L, Kaur, A, Djenderedjian, A.Neuropsychological characteristics of nondepressed adults with obsessive-compulsive disorder. Neuropsychiatry Neuropsychol Behav Neurol 1991;4:96109.
67.Cavallaro, R, Cavedini, P, Mistretta, P et al. Basalcorticofrontal circuits in schizophrenia and obsessive-compulsive disorder: a controlled, double dissociation study. Biol Psychiatry 2003;54:437443.
68.Kim, MS, Park, SJ, Shin, MS, Kwon, JS.Neuropsychological profile in patients with obsessive compulsive disorder over a period of 4 month treatment. J Psychiatric Res 2002;36:257265.
69.Roth, RM, Baribeau, J, Milovan, DL, O'Connor, K.Speed and accuracy on tests of executive function in obsessive-compulsive disorder. Brain Cogn 2004;54: 263265.
70.Fenger, MM, Gade, A, Adams, KH, Hansen, ES, Bolwig, TG, Knudsen, GM.Cognitive deficits in obsessive-compulsive disorder on tests of frontal lobe functions. Nord J Psychiatry 2005;59:3944.
71.Welsh, MC, Pennington, BF, Groisser, DB.A normative-developmental study of executive function: a window on prefrontal function in children. Dev Neuropsychol 1991;7:131149.
72.Hervey, AS, Epstein, JN, Curry, JF.Neuropsychology of adults with attention-deficit/hyperactivity disorder: a meta-analytic review. Neuropsychology 2004;18:485503.
73.Romine, CB, Lee, D, Wolfe, ME, Homack, S, George, C, Riccio, CA.Wisconsin Card Sorting Test with children: a meta-analytic study of sensitivity and specificity. Arch Clin Neuropsychol 2004;19:10271041.
74.Evans, DW, Lewis, MD, Iobst, E.The role of the orbitofrontal cortex in normally developing compulsive-like behaviors and obsessive-compulsive disorder. Brain Cogn 2004;55:220234.
75.Chamberlain, SR, Blackwell, AD, Fineberg, NA, Robbins, TW, Sahakian, BJ.The neuropsychology of obsessive compulsive disorder: the importance of failures in cognitive and behavioural inhibition as candidate endophenotypic markers. Neurosci Biobehav Rev 2005;29:399419.
76.Tolin, DF, Hamlin, C, Foa, EB.Directed forgetting in obsessive-compulsive disorder: replication and extension. Behav Res Ther 2002;40:793803.
77.Voglmaier, MM, Seidman, LJ, Niznikiewicz, MA, Dickey, CC, Shenton, ME, McCarley, RW.Verbal and nonverbal neuropsychological test performance in subjects with schizotypal personality disorder. Am J Psychiatry 2000;157:787793.

Keywords

Metrics

Full text views

Total number of HTML views: 0
Total number of PDF views: 0 *
Loading metrics...

Abstract views

Total abstract views: 0 *
Loading metrics...

* Views captured on Cambridge Core between <date>. This data will be updated every 24 hours.

Usage data cannot currently be displayed