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Neuropsychological profiles of patients with obsessive-compulsive disorder: early onset versus late onset

Published online by Cambridge University Press:  13 December 2006

Clinical Research Center, Seoul National University Hospital, Seoul, South Korea Department of Psychology, Sungshin Women's University, Seoul, Korea
Clinical Research Center, Seoul National University Hospital, Seoul, South Korea Department of Psychiatry, Seoul National University College of Medicine, Seoul, Korea BK21 Life Sciences & Neuroscience Institute, SNU-MRC, Seoul, Korea
Clinical Research Center, Seoul National University Hospital, Seoul, South Korea Department of Psychology, Sungshin Women's University, Seoul, Korea
BK21 Life Sciences & Neuroscience Institute, SNU-MRC, Seoul, Korea
Clinical Research Center, Seoul National University Hospital, Seoul, South Korea BK21 Life Sciences & Neuroscience Institute, SNU-MRC, Seoul, Korea
Department of Psychology, Sungshin Women's University, Seoul, Korea


In this study, we assess the neuropsychological profiles of both early and late symptom-onset obsessive-compulsive disorder (OCD) patients. The early and late-onset OCD patients are compared to the control group with a series of neuropsychological measurements. The late-onset OCD patients exhibited impaired performance on the immediate and the delayed recall conditions of the Rey-Osterrieth Complex Figure Test (RCFT) and the letter and category fluency of the Controlled Oral Word Association Test (COWA), compared to the normal controls and the early-onset OCD patients. The controls and early-onset OCD patients did not differ on any of the neuropsychological measurements taken in this study. These results suggest that different neurophysiological mechanisms are in play in early and late-onset OCD patients, and age of onset can serve as a potential marker for the subtyping of OCD. (JINS, 2007, 13, 30–37.)

Research Article
© 2007 The International Neuropsychological Society

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Abbruzzese, M., Ferri, S., & Scarone, S. (1995). Wisconsin card sorting test performance in obsessive-compulsive disorder: No evidence for involvement of dorsolateral prefrontal cortex. Psychiatry Research, 58, 3743.Google Scholar
American Psychiatric Association. (1994). Diagnostic and statistical manual of mental disorder. 4th ed. Washington: American Psychiatric Association.
Arts, W., Hoogduin, K., Schaap, C., & de Haan, E. (1993). Do patients suffering from obsessions alone differ from other obsessive-compulsives? Behavior Research and Therapy, 31, 119123.Google Scholar
Aylward, E.H., Harris, G.I., Hoehn-Saric, R., Barta, P.E., Machlin, S.R., & Pearlson, G.D. (1996). Normal caudate nucleus in obsessive-compulsive disorder assessed by quantitative neuroimaging. Archives of General Psychiatry, 53, 577584.Google Scholar
Baxter, L.R., Schwartz, J.M., Bergman, K.S., Szuba, M.P., Guze, B.H., & Mazziotta, J.C. (1992). Caudate glucose metabolic rate changes with both drug and behavior therapy for obsessive-compulsive disorder. Archives of General Psychiatry, 49, 681689.Google Scholar
Beck, A., Ward, C., Mendelson, M., Mock, J., & Frbaugh, J. (1961). An inventory for measuring depression. Archives of General Psychiatry, 4, 561591.Google Scholar
Beck, A., Epstein, N., Brown, G., & Robert, A.S. (1988). An inventory for measuring clinical anxiety: Psychometric properties. Journal of Consult Clinical Psychology, 56, 893897.CrossRefGoogle Scholar
Braun, A., Randolph, C., Stoetter, B., Mohr, E., Cox, C., Vladar, K., Sexton, R., Carson, E., Herscovitch, P., & Chase, T. (1995). The functional neuroanatomy of Tourette's syndrome: An FDG-PET study II: Relationships between regional cerebral metabolism and associated behavioral and cognitive features of the illness. Neuropsychopharmacology, 13, 151168.Google Scholar
Busatto, G.F., Buchpiguel, C.A., Zamignani, D.R., Garrido, G.E.J., Glabus, M.F., Rosario-Campos, M.C., Castro, C.C., Maia, A., Rocha, E.T., Mcguire, P.K., & Miguel, E.C. (2001). Regional cerebral blood flow abnormalities in early-onset obsessive-compulsive disorder: An exploratory SPECT study. Journal of the American Academy of Child and Adolescent Psychiatry, 40, 347354.Google Scholar
Cantor-Graae, E., Warkentin, S., Franzen, G., & Risberg, J. (1993). Frontal lobe challenge: A comparison of activation procedures during rCBF measurement in normal subjects. Neuropsychiatry, Neuropsychology and Behavioral Neurology, 6, 8392.Google Scholar
Chervinsky, A.B., Mitrushina, M., & Satz, P. (1992). Comparison of four methods of scoring the Rey-Osterrieth Complex Figure Drawing Test on four age groups of normal elderly. Brain Dysfunction, 5, 267287.Google Scholar
Chiulli, S.J., Haalaud, K.Y., LaRue, A., & Garry, P.J. (1995). Impact of age on drawing the Rey-Osterrieth Figure. The Clinical Neuropsychologist, 9, 219224.Google Scholar
Christensen, K.J., Kim, S.W., Dysken, M.W., & Hoover, K.M. (1992). Neuropsychological performance in obsessive-compulsive disorder. Biological Psychiatry, 31, 418.Google Scholar
Crowe, S.F. (1992). Dissociation of two frontal lobe syndromes by a test of verbal fluency. Journal of Clinical and Experimental Neuropsychology, 14, 327339.Google Scholar
Deckersbach, T., Savage, C.R., Henin, A., Mataix-Cols, D., Otto, M.W., Wilhelm, S., Rauch, S.L., Baer, L., & Jenike, M.A. (2000). Reliability and validity of a scoring system for measuring organizational approach in the Complex Figure Test. Journal of Clinical and Experimental Neuropsychology, 22, 640648.Google Scholar
Devinsky, O., Morrell, M.J., & Vogt, B.A. (1995). Contributions of anterior cingulated cortex to behavior. Brain, 118, 279306.Google Scholar
First, M.B., Spitzer, R.L., Gibbon, M., & Williams, J.B.W. (1996). Structured clinical interview for DSM-IV Axis I disorder. NY: New York State Psychiatric Institute.
Gilbert, A.R., Moore, G.J., Keshavan, M.S., Paulson, L.A., Narula, V., Mac Master, F.P., Stewart, C.M., & Rosenberg, D.R. (2000). Decrease in thalamic volumes of pediatric patients with obsessive-compulsive disorder who are taking paroxetine. Archives of General Psychiatry, 57, 449456.Google Scholar
Goodman, W., Price, L., Rasmussen, S., Mazure, C., Fleischmann, R.L., & Hill, C.L. (1989). The Y-BOCS(1). development, use and reliability. Archives of General Psychiatry, 46, 10061011.Google Scholar
Grachev, I.D., Breiter, H.C., Rauch, S.L., Scott, L., Savage, C.R., Baer, L., Shera, D.M., Kennedy, D.N., Makris, N., Caviness, V.S., & Jenike, M.A. (1998). Structural abnormalities of frontal neocortex in obsessive-compulsive disorder. Archives of General Psychiatry, 55, 181182.Google Scholar
Head, D., Bolton, D., & Hymas, N. (1989). Deficit in cognitive shifting ability in patients with obsessive-compulsive disorder. Biological Psychiatry, 25, 929937.Google Scholar
Heaton, R.K. (1981). Wisconsin Card Sorting Test Manual. Odessa, FL: Psychological Assessment Cooperation Press.
Hemmings, S.M.J., Kinnear, C.J., Lochner, C., Niehaus, D.J.H., Knowles, J.A., Moolman-Smook, J.C., Corfield, V.A., & Stein, D.J. (2004). Early- versus late-onset obsessive-compulsive disorder: Investigating genetic and clinical correlates. Psychiatry Research, 128, 175182.Google Scholar
Hoehn-Saric, R. & Barksdale, V.C. (1983). Impulsiveness in obsessive-compulsive patients. British Journal of Psychiatry, 143, 177182.Google Scholar
Jaisoorya, T.S., Janardhan Reddy, Y.C., & Srinath, S. (2003). The relationship of obsessive-compulsive disorder to putative spectrum disorders: Results from an India study. Comprehensive Psychiatry, 44, 317323.Google Scholar
Kim, B.N. (2003). Child and adolescent onset obsessive-compulsive disorder. Korean Journal of Psychopharmacology, 14, 119128.Google Scholar
Kim, J.J., Lee, M.C., Kim, J.S., Kim, I.Y., Kim, S.I., Han, M.H., Chang, K.H., & Kwon, J.S. (2001). Grey matter abnormalities in obsessive-compulsive disorder: Statistical parametric mapping of segmented magnetic resonance images. British Journal of Psychiatry, 179, 330334.CrossRefGoogle Scholar
Lezak, M.D. (1995). Neuropsychological assessment, 3rd ed. New York: Oxford.
Martin, A., Pigott, J.A., Lalonde, F.M., Dalton, I., Dubbert, B., & Murphy, D.L. (1993). Lack of evidence for Hungtington's disease-like cognitive function in obsessive-compulsive disorder. Biological Psychiatry, 33, 345353.CrossRefGoogle Scholar
Martinot, J.L., Allilaire, J.F., Mazoyer, B.M., Hantouche, E., Huret, J.D., Legaut-Demare, F., Deslauriers, A.G., Hardy, P., Pappata, S., & Baron, J.C. (1990). Obsessive-compulsive disorder: A clinical, neuropsychological and positron emission tomography study. Acta Psychiatric Scandinavia, 82, 233242.Google Scholar
Mataix-Cols, D., Junque, C., Sanchez-Turet, M., Vallezo, J., Verger, K., & Barrios, M. (1999). Neuropsychological functioning in a subclinical obsessive-compulsive sample. Biological Psychiatry, 45, 898904.Google Scholar
Meyers, J.E. & Meyers, K.R. (1995). Rey Complex Figure Test and Recognition Trial. Lutz, FL: Psychological Assessment Resources, Inc.
Miceli, G., Caltagirone, C., Gainotti, G., Masullo, C., & Sillveri, M.C. (1981). Neuropsychological correlates of localized cerebral lesions in nonaphasic brain-damaged patients. Journal of Clinical Neuropsychology, 3, 5363.Google Scholar
Parks, R.W., Loewenstein, D.A., Dodrill, K.L., Barker, W.W., Yoshii, F., Chang, J.Y., Emran, A., Apicella, A., Sheramata, W.A., & Duara, R. (1988). Cerebral metabolic effects of a verbal fluency test: A PET scan study. Journal of Clinical and Experimental Neuropsychology, 10, 565575.Google Scholar
Pauls, D.L. (1992). The genetics of obsessive compulsive disorder and Gilles de la Tourette's syndrome. The Psychiatric Clinics of North America, 15, 759766.Google Scholar
Pauls, D.L. (1996). Genetics of the Gilles de la Tourette's syndrome and obsessive compulsive disorder. European Neuropsychopharmacology, 6, S4.Google Scholar
Perani, D., Colombo, C., Bressi, S., Bonfanti, A., Grass, F., Scarone, S., Bellodi, L., Smeraldi, E., & Fazio, F. (1995). [18F] FDG PET study in obsessive-compulsive disorder: A clinical/metabolic correlation study after treatment. British Journal of Psychiatry, 166, 244250.Google Scholar
Pujol, J., Torres, L., Deus, J., Cardoner, N., Pifarre, J., Capdevila, A., & Vallejo, J. (1999). Functional magnetic resonance imaging study of frontal lobe activation during word generation in obsessive-compulsive disorder. Biological Psychiatry, 45, 891897.Google Scholar
Purcell, R., Maruff, P., Kyrios, M., & Pantelis, C. (1998). Cognitive deficits in obsessive-compulsive disorder on tests of frontal-striatal function. Biological Psychiatry, 43, 348357.Google Scholar
Rauch, S.L., Kolk, B.A., Fisler, R.E., Alpert, N.M., Orr, S.P., Savage, C.R., Fischman, A.J., Jenike, M.A., & Pitman, R.K. (1996). A symptom provocation study of posttraumatic stress disorder using positron emission tomography and script-driven imagery. Archives of General Psychiatry, 53, 380387.Google Scholar
Rauch, S.L., Savage, C.R., Alpert, N.M., Dougherty, D., Kendrick, A., & Curran, T. (1997). Probing striatal function in obsessive-compulsive disorder: A PET study of implicit sequence learning. Journal of Neuropsychiatry and Clinical Neuroscience, 9, 568573.Google Scholar
Rauch, S.L. (2000). Neuroimaging research and the neurobiology of obsessive-compulsive disorder: Where do we go from here? Biological Psychiatry, 47, 168170.Google Scholar
Ravizza, L., Maina, G., & Bogetto, F. (1997). Episodic and chronic obsessive-compulsive disorder. Depress Anxiety, 6, 154158.Google Scholar
Reitan, R.M. & Wolfson, D. (1985). The Halstead-Reitan neuropsychological test battery. Tucson, AZ: Neuropsychology Press.
Rosario-Campos, M.C., Leckman, J.F., Mercadante, M.T., Shavitt, R.G., Prado, H.S., Sada, P., Zamignani, D., & Miguel, E.C. (2001). Adults with early-onset obsessive-compulsive disorder. American Journal of Psychiatry, 158, 18991903.Google Scholar
Roth, R.M., Milovan, D., Baribeau, J., & O'Connor, K. (2005). Neuropsychological functioning in early- and late-onset obsessive-compulsive disorder. Journal of Neuropsychiatry and Clinical Neuroscience, 17, 208213.Google Scholar
Savage, C.R., Baer, L., Keuthen, N.J., Brown, H.D., Rauch, S.L., & Jenike, M.A. (1999). Organizational strategies mediate nonverbal memory impairment in obsessive-compulsive disorder. Biological Psychiatry, 45, 905916.Google Scholar
Schmidtke, K., Schorb, A., Winkelmann, G., & Hohagen, F. (1998). Cognitive frontal lobe dysfunction in obsessive-compulsive disorder. Biological Psychiatry, 43, 666673.Google Scholar
Shin, M.S., Park, S.J., Kim, M.S., Lee, Y.H., Ha, T.H., & Kwon, J.S. (2004a). Deficits of Organizational Strategy and Visual Memory in Obsessive–Compulsive Disorder. Neuropsychology, 18, 665672.Google Scholar
Shin, Y.W., Ha, T.H., Kim, S.Y., & Kwon, J.S. (2004b): Association between EEG alpha power and visuospatial function in obsessive-compulsive disorder. Psychiatry and Clinical Neuroscience, 58, 1620.Google Scholar
Shin, Y.W., Kwon, J.S., Kim, J.J., Kang, D.H., Youn, T., Kang, K.W., Kang, E., Lee, D.S., & Lee, M.C. (2006). Altered neural circuit for working memory before and after symptom provocation in patients with obsessive-compulsive disorder. Acta Psychiatrica Scandinavica, 113, 420429.Google Scholar
Silverstein, A.B. (1989). Agreement between a short-form and the full scale as a function of the correlation between them. Journal of Clinical Psychology, 45, 929931.Google Scholar
Szeszko, P.R., Robinson, D., Alvir, J., Ma, J., Bilder, R.M., Lencz, T., Ashtari, M., Wu, H., & Bogerts, B. (1999). Orbital frontal and amygdala volume reductions in obsessive-compulsive disorder. Archives of General Psychiatry, 56, 913919.Google Scholar
Tallis, F., Pratt, P., & Jamani, N. (1999). Obsessive-compulsive disorder, checking and non-verbal memory: A neuropsychological investigation. Behaviour Research and Therapy, 37, 161166.Google Scholar
Veale, D.M., Sahakian, B.J., Owen, A.M., & Marks, I.M. (1996). Specific cognitive deficits in tests sensitive to frontal lobe dysfunction in obsessive-compulsive disorder. Psychological Medicine, 26, 12611269.Google Scholar
Yum, T.H., Park, Y.S., Oh, K.J., Kim, J.G., & Lee, Y.H. (1992). The Manual of Korean-Wechsler Adult Intelligence Scale. Seoul: Korean Guidance Press.